Why is the death rate so high amongst adults with meningitis in Africa?
Improving the outlook for adults in Africa
Dr David Lalloo, Dr Katharine Cartwright, Dr Matthew Kelly, Prof Rob Heyderman, Prof Tom Solomon
- Start Date:
01 July 2009
Liverpool School of Tropical Medicine, Liverpool, UK, Queen Elizabeth Central Hospital, Malawi-Liverpool-Wellcome Research Laboratories, College of Medicine, Blantyre, Malawi
In Africa, death occurs in over half of adults suffering from bacterial meningitis. In those who survive, disability is common. In contrast, in countries such as the UK, death occurs in fewer than in 10% of those affected.
This project has investigated the contribution of HIV and other viruses to this poor outcome.
Samples from 149 Malawian adults with meningitis (115 HIV-positive) and 39 adults without meningitis (24 HIV-positive) were studied. Over half the patients with meningitis died. We found an unexpectedly high rate of EBV virus (the cause of glandular fever and some cancers called lymphomas) and death was more likely in those with EBV as well as bacterial meningitis. When there was also CMV virus (causes brain, eye, lung and gut problems in AIDS patients) as well as EBV in the brain, only 2/10 patients survived.
In work undertaken in Dr Paul Clapham’s laboratory in Massachusetts using the same samples but not funded directly by MRF, the group are beginning to understand how special types of the HIV virus may lead to a higher likelihood of death.
The results will enable researchers to identify new targets for treatment in addition to the usual antibiotics. These treatments may include anti-virus drugs and drugs against HIV that are highly active in the brain.