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Publikasi Scopus 2024 per tanggal 30 April 2024 (334 artikel)
Publikasi Scopus 2024 per tanggal 30 April 2024 (334 artikel)
Maharani, Kartika (57189235094); Dian, Sofiati (55418398700); Ganiem, Ahmad Rizal (35145741500); Imran, Darma (57203976849); Estiasari, Riwanti (55240204000); Ardiansyah, Edwin (57205617822); Andini, Putri Widya (57205414195); Kristina, Fransisca (58866991800); Pangeran, David (57203764449); Chaidir, Lidya (55533200400); Alisjahbana, Bachti (6506944516); Rukmana, Andriansjah (35491487100); Kusumaningrum, Ardiana (57211641695); Adawiyah, Robiatul (57208658742); Subekti, Decy (6603632507); Yunihas
Clinical presentation, management, and outcome of suspected central nervous system infections in Indonesia: a prospective cohort study
2024
Infection
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2
583
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https://www.scopus.com/inward/record.uri?eid=2-s2.0-85184246183&doi=10.1007%2fs15010-023-02170-0&partnerID=40&md5=5efb373dfbda7111918c324bb66e9406
Department of Neurology, Faculty of Medicine, Dr. Cipto Mangunkusumo, General Hospital, Universitas Indonesia, Jakarta, Indonesia; Department of Neurology, Faculty of Medicine, Dr. Hasan Sadikin General Hospital, Universitas Padjadjaran, Bandung, Indonesia; Research Center for Care and Control of Infectious Disease (RC3ID), Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia; Department of Microbiology, Faculty of Medicine, Dr. Cipto Mangunkusumo General Hospital, Universitas Indonesia, Jakarta, Indonesia; Department of Parasitology, Faculty of Medicine, Dr. Cipto Mangunkusumo General Hospital, Universitas Indonesia, Jakarta, Indonesia; Oxford University Clinical Research Unit Indonesia, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia; Department of Internal Medicine, Faculty of Medicine, Dr. Cipto Mangunkusumo General Hospital, Universitas Indonesia, Jakarta, Indonesia; Department of Radiology, Faculty of Medicine, Dr. Cipto Mangunkusumo General Hospital, Universitas Indonesia, Jakarta, Indonesia; Department of Microbiology, Radboud Centre for Infectious Diseases (RCI), Radboud University Medical Centre, Nijmegen, Netherlands; Department of Internal Medicine, Radboud Centre for Infectious Diseases (RCI), Radboud University Medical Centre, Nijmegen, Netherlands; Center for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
Background: Little is known about the etiology, clinical presentation, management, and outcome of central nervous system (CNS) infections in Indonesia, a country with a high burden of infectious diseases and a rising prevalence of HIV. Methods: We included adult patients with suspected CNS infections at two referral hospitals in a prospective cohort between April 2019 and December 2021. Clinical, laboratory, and radiological assessments were standardized. We recorded initial and final diagnoses, treatments, and outcomes during 6 months of follow-up. Results: Of 1051 patients screened, 793 were diagnosed with a CNS infection. Patients (median age 33 years, 62% male, 38% HIV-infected) presented a median of 14 days (IQR 7–30) after symptom onset, often with altered consciousness (63%), motor deficits (73%), and seizures (21%). Among HIV-uninfected patients, CNS tuberculosis (TB) was most common (60%), while viral (8%) and bacterial (4%) disease were uncommon. Among HIV-infected patients, cerebral toxoplasmosis (41%) was most common, followed by CNS TB (19%), neurosyphilis (15%), and cryptococcal meningitis (10%). A microbiologically confirmed diagnosis was achieved in 25% of cases, and initial diagnoses were revised in 46% of cases. In-hospital mortality was 30%, and at six months, 45% of patients had died, and 12% suffered from severe disability. Six-month mortality was associated with older age, HIV, and severe clinical, radiological and CSF markers at presentation. Conclusion: CNS infections in Indonesia are characterized by late presentation, severe disease, frequent HIV coinfection, low microbiological confirmation and high mortality. These findings highlight the need for earlier disease recognition, faster and more accurate diagnosis, and optimized treatment, coupled with wider efforts to improve the uptake of HIV services. © The Author(s) 2024.
Adult; Central Nervous System Infections; Female; HIV Infections; Humans; Indonesia; Male; Meningitis, Cryptococcal; Prospective Studies; adult; altered state of consciousness; Article; bacterial meningitis; CD4 lymphocyte count; central nervous system infection; central nervous system tuberculosis; cerebral toxoplasmosis; cerebrospinal fluid analysis; clinical feature; clinical outcome; cohort analysis; controlled study; cryptococcal meningitis; female; follow up; hospitalization; human; Human immunodeficiency virus infected patient; Human immunodeficiency virus infection; in-hospital mortality; Indonesia; lumbar puncture; major clinical study; male; neuroimaging; neurosyphilis; patient referral; prevalence; prognosis; prospective study; Rankin scale; central nervous system infection; com
National Institutes of Health, NIH, (R01AI145781); National Institutes of Health, NIH; National Institute of Allergy and Infectious Diseases, NIAID; Medical Research Council, MRC, (MR/S004963/1); Medical Research Council, MRC
This work was supported by the National Institute Of Allergy And Infectious Diseases of the National Institutes of Health (Grant Number R01AI145781) and Medical Research Council UK (Grant Number MR/S004963/1). This study was carried out as part of the routine work.
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