Acute Encephalitis and Meningoencephalitis in Children in University Teaching Hospitals of Ouagadougou, Burkina Faso

Abstract

Introduction: Acute encephalitis and meningoencephalitis (AEM) are important causes of morbidity, mortality, and neurological sequelae in children, particularly in sub-Saharan Africa, where access to advanced diagnostic tools remains limited. Local multicentre data describing their clinical presentation, aetiological profile, and outcomes remain scarce in Burkina Faso. Aims: This study aimed to describe the clinical, laboratory, aetiological, and outcome characteristics of paediatric AEM in university teaching hospitals in Ouagadougou, Burkina Faso. Methods: This descriptive observational study used retrospective and prospective data collection over a 33-month period, from January 2021 to September 2023. Children aged 29 days to 14 years who were admitted to the four university teaching hospitals in Ouagadougou and met either the International Encephalitis Consortium 2013 criteria for acute encephalitis or meningoencephalitis or the diagnostic criteria for cerebral malaria were included. Results: A total of 103 children were included, representing a hospital frequency of 0.67% among 15,263 paediatric admissions. The mean age was 3.04 ± 1.6 years, and 53 patients (51.5%) were female. Seizures (97.0%), impaired consciousness (92.2%), meningeal syndrome (84.4%), fever (69.9%), and focal neurological signs (53.4%) were the main clinical manifestations. Lumbar puncture was performed in 90 patients (87.4%). An infectious agent was microbiologically confirmed in 21 patients (20.4%). Post-infectious encephalitis was the most frequently assigned category (39.8%), followed by cerebral malaria (8.7%), bacterial meningoencephalitis (5.8%), and viral meningoencephalitis (5.8%); no aetiology was identified in 39.8% of cases. Unfavourable outcomes occurred in 57.3% of patients, including neurological sequelae in 42.7% and death in 14.6%. Conclusion: Paediatric AEM in Ouagadougou was associated with substantial mortality and neurological morbidity. The findings reflect the local infectious and diagnostic context and support the need to strengthen diagnostic capacity, preventive strategies and early clinical management.