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Viral pathogens in children hospitalized with features of central nervous system infection in a malaria-endemic region of Papua New Guinea.

Abstract：

BACKGROUND:Viral central nervous system (CNS) infections are common in countries where malaria is endemic but, due to limited laboratory facilities, few studies have systematically examined the prevalence and clinical consequences of the presence of viruses in cerebrospinal fluid (CSF) from children with suspected CNS infection. METHODS:We performed a prospective study of Papua New Guinean children hospitalized with signs and symptoms of CNS infection. CSF samples from 300 children without proven bacterial/fungal meningitis were analyzed for human herpes viruses (HHV), picornaviruses, influenza, adenoviruses, flaviviruses and bacteria. RESULTS:Fifty-five children (18%) had viral (42), bacterial (20) or both viral and bacterial (7) nucleic acids (NA) identified in their CSF. Human herpes viruses accounted for 91% of all viruses found. The identification of viral or bacterial NA was not associated with any characteristic clinical features. By contrast, malaria was associated with increased identification of viral and bacterial NA and with impaired consciousness, multiple convulsions and age. Malaria was also inversely associated with an adverse outcome. Amongst children with HHV infection, those with HHV-6 and -7 were younger, were more likely have impaired consciousness and had a higher proportion of adverse outcomes than children with CMV. Dengue and enteroviral infections were infrequent. Adenoviral and influenza infections were not identified. CONCLUSION:Infections with HHV-6, HHV-7, dengue and enterovirus have the potential to cause serious CNS disease in young PNG children. However most HHVs in this malaria-endemic setting should be considered to be the result of reactivation from a latent reservoir without clinical sequelae.

journal_name

BMC Infect Dis

journal_title

BMC infectious diseases

authors

Laman M,Hwaiwhanje I,Bona C,Warrel J,Aipit S,Smith D,Noronha J,Siba P,Mueller I,Betuela I,Davis TM,Manning L

doi

10.1186/s12879-014-0630-0

subject

Has Abstract

pub_date

2014-11-26 00:00:00

pages

630

issn

1471-2334

pii

s12879-014-0630-0

journal_volume

pub_type

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Viral pathogens in children hospitalized with features of central nervous system infection in a malaria-endemic region of Papua New Guinea.