Clinical Presentation and Outcome of Toxoplasma Encephalitis in HIV-Infected Patients from Zaria, Northern Nigeria

Ogoina, Dimie; Obiako, Reginald; Onyemelukwe, G.C.; Musa, Bolanle O. P.; Hamidu, Ahmed Umdagas

doi:10.1177/2325957413500529

Cited by 9 publications

(7 citation statements)

References 8 publications

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“…Toxoplasmosis and HIV co-infected persons are at increased risk of developing TE with the majority of TE cases 85–95%, due to reactivation, mostly affecting the CNS with very occasional involvement of retina and lungs. The reported frequency of TE in HIV varies significantly within Africa from 0–1% in parts of SA/Botswana/Uganda/Malawi to 2.7% in Kenya and increases to 10% in West Africa and Ethiopia2,6,11,32,89,90. In the post ART era in Africa the reported frequency varies from 0–10% with the highest rates in West Africa11.…”

Section: Resultsmentioning

confidence: 99%

Neurological disorders in HIV in Africa: a review

Howlett¹

2019

Afr H. Sci.

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BackgroundNeurological disorders in HIV infection are a common cause of morbidity and mortality. The aim of this paper is to provide a narrative overview of up to date information concerning neurological disorders affecting HIV infected persons in Africa.MethodsSeminal research concerning neurological disorders among HIV-infected adults in sub-Saharan Africa from prior to 2000 was combined with an in-depth search of PubMed to identify literature published from 2000 to 2017. The following Mesh terms were used. “Nervous System Diseases” “HIV Infections” and “Africa South of the Sahara” and “Seizures” or “Spinal Cord Diseases” or “Peripheral Nervous System Diseases” or “AIDS Dementia Complex” or “Opportunistic Infections” or “Immune Reconstitution Inflammatory Syndrome” or “Stroke”. Only those articles written in English were used. A total of 352 articles were identified, selected and reviewed and 180 were included in the study. These included case series, observational studies, interventional studies, guidelines and reviews with metanalyses. The author also included 15 publications on the subject covering the earlier phase of the HIV epidemic in Africa from 1987 to 1999 making a total of 195 references in the study. This was combined with extensive personal experience diagnosing and treating these neurological disorders.ResultsNeurological disorders were common, typically occurring in WHO stages III/IV. These were in three main categories: those arising from opportunistic processes mostly infections, direct HIV infection and autoimmunity. The most common were those arising from direct HIV infection occurring in >50%. These included HIV-associated neurocognitive dysfunction (HAND), neuropathy and myelopathy. Opportunistic infections occurred in >20% and frequently had a 6–9-month mortality rate of 60–70%. The main causes were cryptococcus, tuberculosis, toxoplasmosis and acute bacterial meningitis. Concurrent systemic tuberculosis occurred in almost 50%.ConclusionNeurological disorders are common in HIV in Africa and the main CNS opportunistic infections result in high mortality rates. Strategies aimed at reducing their high burden, morbidity and mortality include early HIV diagnosis and anti-retroviral therapy (ART), screening and chemoprophylaxis of main opportunistic infections, improved clinical diagnosis and management and programme strengthening.

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Section: Resultsmentioning

confidence: 99%

Neurological disorders in HIV in Africa: a review

Howlett¹

2019

Afr H. Sci.

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“…Silva FCD et al and some others study reported that TE was significantly associated with CD4 counts (p<0.001), taking HAART (p=0.013). [11][12][13][14][15] Lavu EK et reported that TE was significantly associated with lymphocyte levels (p=0.000). 16 This study revealed that statistically there were not significant association between possible risk factors: age (p=0.655), sex (p=0.454) ( Table 2).…”

Section: Discussionmentioning

confidence: 99%

Risk factors of Toxoplasma encephalitis among people living with HIV/AIDS at Wangaya hospital in Denpasar, Bali, Indonesia: a case control study

Suharsono

Suryana²,

Pujasakti³

2020

Int J Adv Med

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Background: Toxoplasma encephalitis (TE) is the most frequent AIDS-related opportunistic infection. T. gondii infects the human population in both developed and developing countries. Toxoplasmosis among PLWHA manifests primarily as a life-threatening condition, TE, brain abscesses and death. Objective was to identify the risk factors of Toxoplasma encephalitis (TE) among people living with HIV/AIDS (PLWHA). Methods: A case control study was conducted during May to November 2018. The study participants consisted of 90 PLWHA; 30 PLWHA with history of TE (cases) and 60 PLWHA without history of TE (controls). Data such as: socio-demographic, laboratory results, head CT scan findings were collected from the medical record and was analyzed using SPSS version 18.Results: A total of 90 participants PLWHA were enrolled, 30 participants as cases and 60 participants as a control. 49 (54.4%) participants were males and 41 (45.6%) participants were females. Among the risk factors evaluated; the lower lymphocyte level (p=0.016), the lower cluster differentiation (CD) 4 level (p=0.003), no taking highly active antiretroviral therapy (HAART) (p=0.000) were observed to be an independent associated risk factor of TE.Conclusions: Our findings suggest lower lymphocyte levels, lower CD4 count and no taking HAART may constitute a significant associated risk factor for TE in PLWHA.

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“…It has been estimated worldwide that 1/3 of AIDS patients seropositive for T. gondii and with low T cell count (< 200/ml) develop reactivated TE (124). While data is limited, African studies indicate that TE remains a major problem associated to AIDS, with variability among regions and countries (167)(168)(169)(170). The strong association of TE with HIV/AIDS likely depends on failure to control CNS-resident parasites due to compromised antiparasitic T cell responses.…”

Section: Manifestations Of Neurological Diseasementioning

confidence: 99%

Neuroimmunology of Common Parasitic Infections in Africa

et al. 2022

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Parasitic infections of the central nervous system are an important cause of morbidity and mortality in Africa. The neurological, cognitive, and psychiatric sequelae of these infections result from a complex interplay between the parasites and the host inflammatory response. Here we review some of the diseases caused by selected parasitic organisms known to infect the nervous system including Plasmodium falciparum, Toxoplasma gondii, Trypanosoma brucei spp., and Taenia solium species. For each parasite, we describe the geographical distribution, prevalence, life cycle, and typical clinical symptoms of infection and pathogenesis. We pay particular attention to how the parasites infect the brain and the interaction between each organism and the host immune system. We describe how an understanding of these processes may guide optimal diagnostic and therapeutic strategies to treat these disorders. Finally, we highlight current gaps in our understanding of disease pathophysiology and call for increased interrogation of these often-neglected disorders of the nervous system.

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Clinical Presentation and Outcome of Toxoplasma Encephalitis in HIV-Infected Patients from Zaria, Northern Nigeria

Cited by 9 publications

References 8 publications

Neurological disorders in HIV in Africa: a review

Neurological disorders in HIV in Africa: a review

Risk factors of Toxoplasma encephalitis among people living with HIV/AIDS at Wangaya hospital in Denpasar, Bali, Indonesia: a case control study

Neuroimmunology of Common Parasitic Infections in Africa

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