ArticleThe Journal of infection2019
Epidemiology of adult meningitis during antiretroviral therapy scale-up in southern Africa: Results from the Botswana national meningitis survey.
Article in The Journal of infection, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 18 citations in OpenAlex.
- Single-Dose Liposomal Amphotericin B Treatment for Cryptococcal Meningitis.The New England journal of medicine · 2022Trial
- Characteristics and Distribution of Fungal Meningitis: A Systematic Review.Infectious diseases & clinical microbiology · 2025Article
- Computed Tomography of the Head Before Lumbar Puncture in Adults With Suspected Meningitis in High-HIV Prevalence Settings.Open forum infectious diseases · 2024Article
- The Impact of GeneXpert Cerebrospinal Fluid Testing on Tuberculous Meningitis Diagnosis in Routine Care in Botswana.Open forum infectious diseases · 2024Article
- Tracking Cryptococcal Meningitis to Monitor HIV Program Success During the Treat All Era: An Analysis of National Data in Botswana.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024Article
- Cryptococcal Meningitis in HIV-Negative Patients: A 12-Year Single-Center Experience in China.Journal of clinical medicine · 2023Article
- Invasive Fungal Diseases in Africa: A Critical Literature Review.Journal of fungi (Basel, Switzerland) · 2022Article
- Human Herpesvirus-6 Detection in Cerebrospinal Fluid on the BioFire FilmArray Meningitis/Encephalitis Panel in a High Human Immunodeficiency Virus-Prevalence African Setting.Open forum infectious diseases · 2022Article
- Reversal of CSF HIV-1 Escape during Treatment of HIV-Associated Cryptococcal Meningitis in Botswana.Biomedicines · 2022Article
- The global burden of tuberculous meningitis in adults: A modelling study.PLOS global public health · 2021Article
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Authors and funding
20 authors at 9 institutions in 3 countries.
Funding
Abstract
objectivesData on meningitis epidemiology in high HIV-prevalence African settings following antiretroviral therapy scale-up are lacking. We described epidemiology of adult meningitis in Botswana over a 16-year period.
methodsLaboratory records for adults undergoing lumbar puncture (LP) 2000-2015 were collected, with complete national data 2013-2014. Cerebrospinal fluid (CSF) findings and linked HIV-data were described, and national incidence figures estimated for 2013-2014. Temporal trends in meningitis were evaluated.
resultsOf 21,560 adults evaluated, 41% (8759/21,560) had abnormal CSF findings with positive microbiological testing and/or pleocytosis; 43% (3755/8759) of these had no confirmed microbiological diagnosis. Of the 5004 microbiologically-confirmed meningitis cases, 89% (4432/5004) were cryptococcal (CM) and 8% (382/5004) pneumococcal (PM). Seventy-three percent (9525/13,033) of individuals undergoing LP with identifiers for HIV registry linkage had documented HIV-infection. Incidence of LP for meningitis evaluation in Botswana 2013-2014 was 142.6/100,000 person-years (95%CI:138.3-147.1); incidence of CM was 25.0/100,000 (95%CI:23.2-26.9), and incidence of PM was 2.7/100,000 (95%CI:2.4-3.1). In contrast to previously reported declines in CM incidence with ART roll-out, no significant temporal decline in pneumococcal or culture-negative meningitis was observed.
conclusionsCM remained the predominant identified aetiology of meningitis despite ART scale-up. A high proportion of cases had abnormal CSF with negative microbiological evaluation.
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