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dc.contributor.authorKemigisha, Elizabeth
dc.contributor.authorNanjebe, Deborah
dc.contributor.authorII, Yap Boum
dc.contributor.authorLangendorf, Celine
dc.contributor.authorAberrane, Said
dc.contributor.authorNyehangane, Dan
dc.contributor.authorNackers, Fabienne
dc.contributor.authorMueller, Yolanda
dc.contributor.authorCharrel, Remi
dc.contributor.authorMurphy, Richard A.
dc.contributor.authorPage, Anne-Laure
dc.contributor.authorMwanga-Amumpaire, Juliet
dc.date.accessioned2024-05-13T11:37:10Z
dc.date.available2024-05-13T11:37:10Z
dc.date.issued2018
dc.identifier.citationKemigisha, E., Nanjebe, D., Boum, Y., Langendorf, C., Aberrane, S., Nyehangane, D., ... & Mwanga-Amumpaire, J. (2018). Antimicrobial treatment practices among Ugandan children with suspicion of central nervous system infection. PLoS One, 13(10), e0205316.en_US
dc.identifier.urihttp://ir.must.ac.ug/xmlui/handle/123456789/3643
dc.description.abstractAcute central nervous system (CNS) infections in children in sub-Saharan Africa are often fatal. Potential contributors include late presentation, limited diagnostic capacity and inadequate treatment. A more nuanced understanding of treatment practices with a goal of optimizing such practices is critical to prevent avoidable case fatality. We describe empiric antimicrobial treatment, antibiotic resistance and treatment adequacy in a prospective cohort of 459 children aged two months to 12 years hospitalised for suspected acute CNS infections in Mbarara, Uganda, from 2009 to 2012. Among these 459 children, 155 had a laboratory-confirmed diagnosis of malaria (case-fatality rate [CFR] 14%), 58 had bacterial infections (CFR 24%) and 6 children had mixed malaria and bacterial infections (CFR 17%). Overall case fatality was 18.1% (n = 83). Of 219 children with laboratory-confirmed malaria and/or bacterial infections, 182 (83.1%) received an adequate antimalarial and/or antibiotic on the day of admission and 211 (96.3%) within 48 hours of admission. The proportion of those receiving adequate treatment was similar among survivors and non-survivors. All bacterial isolates were sensitive to ceftriaxone except one Escherichia coli isolate with extended-spectrum beta-lactamase (ESBL). The observed high mortality was not a result of inadequate initial antimicrobial treatment at the hospital. The epidemiology of CNS infection in this setting justifies empirical use of a third-generation cephalosporin, however antibiotic resistance should be monitored closely.en_US
dc.description.sponsorshipMe´decins Sans Frontières- Operational Center Paris (MSF-OCP)en_US
dc.language.isoen_USen_US
dc.publisherPLoS Oneen_US
dc.subjectAcute central nervous system (CNSen_US
dc.subjectInfectionsen_US
dc.subjectChildrenen_US
dc.subjectSub-Saharan Africaen_US
dc.titleAntimicrobial treatment practices among Ugandan children with suspicion of central nervous system infectionen_US
dc.typeArticleen_US


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