Table 2.
Main etiological or syndromic diagnoses of neurological disorders at the rural hospital of Mosango, province of Kwilu, DRC
| Main diagnoses | N = 351 |
|---|---|
| Priority conditions/infections of the central nervous system* | 63 (17.9) |
| Unspecified meningoencephalitis | 19 (5.4) |
| Bacterial meningitis with specified pathogen | 14 (4.0) |
| due to Neisseria meningitidis | 12 (3.4) |
| HIV and related opportunistic infections | 10 (2.8) |
| Second-stage human African trypanosomiasis | 10 (2.8) |
| Cerebral malaria | 5 (1.4) |
| Tuberculosis of the central nervous system | 4 (1.1) |
| Neurosyphilis | 1 (0.3) |
| Other local/systemic infections with neurological manifestations | 60 (17.1) |
| Upper/lower respiratory tract infection | 18 (5.1) |
| Undifferentiated febrile illness (viral or bacterial) | 17 (4.6) |
| Uncomplicated malaria | 10 (2.8) |
| Spinal tuberculosis | 9 (2.5) |
| Tetanus | 3 (0.8) |
| Bacteremia | 3 (0.8) |
| Noncommunicable neurological illnesses/syndromes | 162 (46.1) |
| Epilepsy | 61 (17.3) |
| Cerebrovascular accident | 23 (6.6) |
| Neuropathic syndromes | 19 (5.4) |
| Degenerative neurological diseases | 18 (5.1) |
| Dementia | 9 (2.6) |
| Extrapyramidal disorders | 6 (1.7) |
| Motor neuron disorders | 3 (0.8) |
| Myelopathic syndrome | 12 (3.4) |
| Headache syndrome, unspecified | 9 (2.5) |
| Spondylarthropathy, unspecified | 7 (1.9) |
| Vestibular syndrome | 6 (1.7) |
| Migraine | 4 (1.1) |
| Space-occupying lesion | 3 (0.8) |
| Psychiatric disorders | 56 (16.0) |
| Anxiety depression | 42 (12.0) |
| Psychosis | 14 (3.9) |
| Metabolic or vascular diseases with neurological manifestations | 10 (2.8) |
| Arterial hypertension | 4 (1.1) |
| Hyperglycemia | 2 (0.5) |
| Hypoglycemia | 2 (0.5) |
| Temporalis arteritis | 2 (0.5) |
DRC = Democratic Republic of Congo; HIV = human immunodeficiency virus. All results are expressed as n, (%).
Diagnosis of the priority conditions was obtained with the following investigations (see also Supplemental Table 2): unspecified meninogoencephalitis (presence of > 5 white blood cells (with neutrophil or lymphocyte predominance) in cerebrospinal fluid (CSF) and no etiological pathogen demonstrated (N = 19); bacterial meningitis: positive culture (N = 4); positive Gram stain in cerebrospinal fluid with confirmation by Pastorex antigen test (N = 7), or not (N = 2); positive Pastorex antigen test only (N = 1); human African trypanosomiasis: demonstration of trypanosomes in CSF only (N = 4), in blood and CSF (N = 4), in blood, CSF and lymph node (N = 2); HIV-related neurological disorders: HIV infection confirmed by three successive positive rapid diagnostic tests, with unspecified meningoencephalitis (N = 4), cryptococcal meningitis (N = 3), or cerebral toxoplasmosis (N = 3); cerebral malaria: signs of cerebral dysfunction and blood smear positive for Plasmodium falciparum trophozoites + and exclusion of other etiologies (N = 5); tuberculosis of central nervous system: positive Ziehl stain and GeneXpert in CSF (N = 1), positive GeneXpert in CSF only (N = 2), and abnormal CSF and demonstrated pulmonary tuberculosis (N = 1); and neurosyphilis: positive rapid plasma reagin and Treponema pallidum passive particle agglutination in blood and positive venereal disease research laboratory test in CSF (N = 1).