@article{fdi:010083775,
  title = {{A} clinical, aetiological, and public health perspective on central nervous system infections in {B}olivia, 2017-2018},
  author = {{V}illarroel, {P}. {M}. {S}. and {S}oto, {M}. {D}. {C}. and {F}lores, {O}. {M}. and {L}andivar, {A}. {P}. and {C}alderon, {M}. {E}. and {L}oayza, {R}. and {B}oucraut, {J}. and {T}hirion, {L}aurence and {D}ubot {P}{\'e}r{\`e}s, {A}udrey and {N}inove, {L}. and {L}amballerie, {X}. de},
  editor = {},
  language = {{ENG}},
  abstract = {{C}entral nervous system ({CNS}) infections are important causes of morbidity and mortality worldwide. {I}n {B}olivia, aetiologies, case fatality, and determinants of outcome are poorly characterised. {W}e attempted to investigate such parameters to guide diagnosis, treatment, prevention, and health policy. {F}rom {N}ov-2017 to {O}ct-2018, we prospectively enrolled 257 inpatients (20.2% {HIV}-positive patients) of all ages from healthcare centers of {C}ochabamba and {S}anta {C}ruz, {B}olivia with a suspected {CNS} infection and a lumbar puncture performed. {B}iological diagnosis included classical microbiology, molecular, serological and immunohistochemical tests. {A}n infectious aetiology was confirmed in 128/257 (49.8%) inpatients, including, notably among confirmed single and co-infections, {C}ryptococcus spp. (41.7%) and {M}ycobacterium tuberculosis (27.8%) in {HIV}-positive patients, and {M}ycobacterium tuberculosis (26.1%) and {S}treptococcus pneumoniae (18.5%) in {HIV}-negative patients. {T}he total mortality rate was high (94/223, 42.1%), including six rabies cases. {I}n multivariate logistic regression analysis, mortality was associated with thrombocytopenia ({O}dds ratio ({OR}) 5.40, 95%-{CI} 2.40-11.83) and hydrocephalus ({OR} 4.07, 95%-{CI} 1.35-12.23). {T}he proportion of untreated {HIV} patients, late presentations of neurotuberculosis, the rate of pneumococcal cases, and rabies patients who did not benefit from a post-exposure prophylaxis, suggest that decreasing the burden of {CNS} infections requires reinforcing health policy regarding tuberculosis, rabies, {S}. pneumoniae vaccination, and {HIV}-infections.},
  keywords = {{BOLIVIE} ; {COCHABAMBA} ; {SANTA} {CRUZ}},
  booktitle = {},
  journal = {{S}cientific {R}eports - {N}ature},
  volume = {11},
  numero = {1},
  pages = {23235 [11 ]},
  ISSN = {2045-2322},
  year = {2021},
  DOI = {10.1038/s41598-021-02592-6},
  URL = {https://www.documentation.ird.fr/hor/fdi:010083775},
}