哈拉雷一家中心医院收治患者脑膜炎的病因和危险因素。

A Matubu, S Rusakaniko, V Robertson, L Gwanzura
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摘要

目的:了解哈拉雷某三级转诊医院收治的脑膜炎患者的病因及危险因素。设计:横断面研究。地点:城市转诊保健设施。受试者:Parirenyatwa医院收治的疑似脑膜炎患者被连续同意并纳入研究,直到样本量增加。主要结局指标:与脑膜炎相关病原体的患病率。脑膜炎的危险因素。结果:296例临床疑似脑膜炎患者纳入研究,其中51.7% (n=115)为男性。61例(20.6%)确诊脑膜炎,病原菌比例依次为:新生梭菌(45.9%)28例,肺炎链球菌(27.9%)17例,结核分枝杆菌(4.9%)3例,疑似病毒性脑膜炎(6.6%)4例,其他细菌(14.8%)9例。结论:胶乳凝集与脑脊液革兰氏染色和培养联合使用,可增加真菌和细菌病原体的检出率。新生隐球菌和肺炎链球菌是Parirenyatwa医院收治的患者中脑膜炎的主要原因。
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Etiology and risk factors of meningitis in patients admitted at a Central Hospital in Harare.

Objective: To determine etiology and risk factors of meningitis in patients admitted a tertiary referral Hospital in Harare.

Design: Cross-Sectional Study.

Setting: Urban Referral Health Facility.

Subjects: Patients suspected of having Meningitis admitted at Parirenyatwa Hospital were consecutively consented and recruited into the study until sample size accrual.

Main outcome measures: Prevalence of pathogens associated with Meningitis. Risk factors of meningitis.

Results: Two Hundred and Ninety Six (296) clinically suspected meningitis patients were recruited into the study, 51.7 %( n=115) were male. Meningitis was confirmed in 20.6% (n=61) cases with the following pathogen proportions, C. neoformans - 45.9 %( n=28), S. pneumoniae – 27.9 % (n=17), TBM – 4.9 %( n=3), probable viral meningitis – 6.6% (n=4 and other bacteria- 14.8% (n=9). Patients from crowded households were also more likely to suffer from meningitis than those from sparsely populated households (p<0.001).

Conclusion: The use of Latex agglutination increases the proportion of detected pathogens both fungal and bacterial when used in conjunction with CSF gram stain and culture. Cryptococcus neoformans and S. pneumoniae are the leading causes of meningitis in patients admitted at Parirenyatwa Hospital.

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