Table 1.
Baseline characteristics and clinical outcome of patients admitted for neurological disorders (N = 351) to the rural hospital of Mosango, province of Kwilu, DRC
| N = 351 | |
|---|---|
| Epidemiological data | |
| Male sex, n (%) | 163 (46.4) |
| Median age, year (Q1–Q3) | 40 (16–64) |
| ≤ 18 years, n (%) | 58 (16.5) |
| 19 to 49 years, n (%) | 181 (51.5) |
| ≥ 50 years, n (%) | 112 (31.9) |
| Median distance to HGR of Mosango, km (Q1–Q3) | 36 (12–125) |
| Residence outside catchment area, n (%) | 116 (33.0) |
| Clinical features | |
| Main neurological presenting symptoms/signs,* n (%) | |
| Severe headache, n (%) | 199 (56.7) |
| With other symptoms/signs of meningism, n (%) | 38 (10.8) |
| Gait/walking disorders, n (%) | 97 (27.6) |
| Epileptic seizure, n (%) | 87 (24.8) |
| Focal sensory-motor deficit and/or cranial nerve lesion, n (%) | 86 (24.5) |
| Cognitive decline and/or behavior disturbance, n (%) | 74 (21.0) |
| Altered state of consciousness, n (%) | 54 (15.4) |
| Change in sleep pattern, n (%) | 51 (14.5) |
| Presence of nonneurological symptoms/signs, n (%) | 135 (38.5) |
| Fever (reported and/or observed), n (%) | 101 (28.8) |
| Respiratory and/or ear-nose-throat symptoms, n (%) | 70 (20.0) |
| Abdominal/digestive symptoms, n (%) | 37 (10.5) |
| Median duration of main symptoms, days (Q1–Q3) | 21 (3–181) |
| Contact with primary care facility before admission, n (%) | 164 (47) |
| Transferred with referral document, n (%) | 79 (22.5) |
| Exposure to treatment before admission, n (%) | 149 (42.4) |
| Antibiotic alone, n (%) | 49 (13.9) |
| Antimalarial alone, n (%) | 41 (11.7) |
| Both antibiotic and antimalarial, n (%) | 59 (16.8) |
| Past medical history, n (%) | 134 (34.4) |
| Tuberculosis, n (%) | 28 (7.9) |
| Psychiatric illness, n (%) | 19 (5.4) |
| Human African trypanosomiasis, n (%) | 12 (3.4) |
| Concomitant medical condition, n (%) | 57 (16) |
| Arterial hypertension, n (%) | 38 (10.8) |
| Diabetes mellitus (insulin-dependent), n (%) | 16 (4.5) |
| Others, n (%) | 3 (0.9) |
| Outcome | |
| Cure, n (%) | 109 (31.1) |
| Stabilized chronic conditions,† n (%) | 97 (27.3) |
| Moderate or severe neurological sequelae, n (%) | 76 (21.6) |
| Lost to follow-up, n (%) | 40 (11.4) |
| Death, n (%) | 29 (8.2) |
DRC = Democratic Republic of Congo; HGR = “Hôpital Général de Référence”; Q1–Q3 = quartiles 25th and 75th.
Number (%) of cases with presence of only one presenting symptom/sign at presentation: 100 (28.4%); of two symptoms/signs: 159 (45.2%); of three symptoms/signs or more: 92 (26.2%).
Stabilized chronic conditions included diseases for which definitive cure could not be ascertained after 6 months of follow-up but which were clinically controlled without sequelae. This group included human African trypanosomiasis (N = 7), tuberculosis (N = 5), HIV infection (N = 5), epilepsy (N = 57), psychosis (N = 12), dementia (N = 6), and arterial hypertension and/or diabetes (N = 5).