Management and outcome of intracranial fungal infections in children and adults in Africa: a scoping review.

Autor: Takoutsing BD; Research Department, Association of Future African Neurosurgeons, Yaounde, Cameroon. takoutsingberjo@gmail.com., Ooi SZY; Research Department, Association of Future African Neurosurgeons, Yaounde, Cameroon., Egu C; Research Department, Association of Future African Neurosurgeons, Yaounde, Cameroon., Gillespie CS; Research Department, Association of Future African Neurosurgeons, Yaounde, Cameroon., Dalle DU; Research Department, Association of Future African Neurosurgeons, Yaounde, Cameroon., Erhabor J; Research Department, Association of Future African Neurosurgeons, Yaounde, Cameroon., Ciuculete AC; Research Department, Association of Future African Neurosurgeons, Yaounde, Cameroon., Kesici Ö; Research Department, Association of Future African Neurosurgeons, Yaounde, Cameroon., Awad AK; Research Department, Association of Future African Neurosurgeons, Yaounde, Cameroon., Dokponou YCH; Research Department, Association of Future African Neurosurgeons, Yaounde, Cameroon., Khan M; Research Department, Association of Future African Neurosurgeons, Yaounde, Cameroon., Ikwuegbuenyi CA; Research Department, Association of Future African Neurosurgeons, Yaounde, Cameroon., Dada OE; Research Department, Association of Future African Neurosurgeons, Yaounde, Cameroon., Bandyopadhyay S; Research Department, Association of Future African Neurosurgeons, Yaounde, Cameroon., Bankole NDA; Research Department, Association of Future African Neurosurgeons, Yaounde, Cameroon.
Jazyk: angličtina
Zdroj: BMC infectious diseases [BMC Infect Dis] 2024 Aug 06; Vol. 24 (1), pp. 789. Date of Electronic Publication: 2024 Aug 06.
DOI: 10.1186/s12879-024-09694-2
Abstrakt: Introduction: Intracranial fungal infections' (IcFIs) varying clinical manifestations lead to difficulties in diagnosis and treatment. African populations are disproportionately affected by the high burden of the disease. There is a lack of clarity as to the diagnostic and treatment modalities employed across the continent. In this review, we aim to detail the management, and outcome of IcFIs across Africa.
Methods: This scoping review was conducted using the Arksey and O'Malley framework. MEDLINE, EMBASE, Cochrane Library, African Index Medicus, and African Journals Online were searched for relevant articles from database inception to August 10th, 2021. The Preferred Reporting Items for Systematic Review and Meta-Analysis extension for Scoping Reviews guidelines were used to report the findings of the review.
Results: Of the 5,779 records identified, 131 articles were included. The mean age was 35.6 years, and the majority (56.4%) were males. The majority (n = 8,433/8,693, 97.0%) of IcFIs presented as a meningitis, the most common communicable predisposing factor of IcFIs was HIV/AIDS (n = 7,815/8,693, 89.9%), and the most common non-communicable risk factor was diabetes mellitus (n = 32/8,693, 0.4%). Cryptococcus species was the most common (n = 8,428/8,693, 97.0%) causative organism. The most commonly used diagnostic modality was cerebrospinal (CSF) cultures (n = 4,390/6,830, 64.3%) for diffuse IcFIs, and MRI imaging (n = 12/30, 40%) for focal IcFIs. The most common treatment modality was medical management with antifungals only (n = 4,481/8,693, 51.6%). The most commonly used antifungal agent in paediatric, and adult patients was amphotericin B and fluconazole dual therapy (51.5% vs 44.9%). The overall mortality rate was high (n = 3,475/7,493, 46.3%), and similar for both adult and paediatric patients (47.8% vs 42.1%).
Conclusion: Most IcFIs occurred in immunosuppressed individuals, and despite the new diagnostic techniques, CSF culture was mostly used in Africa. Antifungals regimens used was similar between children and adults. The outcome of IcFIs in Africa was poor for both paediatric and adult patients.
(© 2024. The Author(s).)
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje