Lumbar puncture refusal in sub-Saharan Africa: A call for further understanding and intervention

doi:10.1212/WNL.0000000000001561

. 2015 May 12;84(19):1988-90.

doi: 10.1212/WNL.0000000000001561.

Lumbar puncture refusal in sub-Saharan Africa: A call for further understanding and intervention

Affiliations

¹ From the Division of Neuroinfectious Diseases and Neuroimmunology, Department of Neurology (K.T.T.), Johns Hopkins Hospital, Baltimore, MD; the Department of Internal Medicine (K.M., L.H., V.K., M.A., O.K.S.), University of Zambia School of Medicine, Lusaka, Zambia; the Department of Internal Medicine (L.H.), University of Maryland School of Medicine, Baltimore, MD; the Department of Pediatrics and Child Health, College of Medicine (M.M.), and the Department of Internal Medicine (J.M.), Queen Elizabeth Central Hospital, Blantyre, Malawi; the Neurology Unit, Department of Internal Medicine (E.O.N.), Federal Medical Center Owerri, Imo State, Nigeria; the Neurology Unit (T.L.), Department of Internal Medicine, Lagos University Teaching Hospital, Lagos State, Nigeria; the Neurology Unit, Department of Internal Medicine (C.B.M.), Jos University Teaching Hospital, Jos, Plateau State, Nigeria; the Division of Infectious Diseases & International Medicine, Department of Medicine (D.R.B.), University of Minnesota, Minneapolis; Epilepsy Division, Department of Neurology (G.L.B.), University of Rochester, NY; the Chikankata Epilepsy Care Team (G.L.B.), Mazabuka, Zambia; and the Global Neurology Program, Division of Neuroimmunology, Center for Virology and Vaccine Research, Department of Neurology (O.K.S.), Beth Israel Deaconess Medical Center, Boston, MA. kthakur1@jhmi.edu.
² From the Division of Neuroinfectious Diseases and Neuroimmunology, Department of Neurology (K.T.T.), Johns Hopkins Hospital, Baltimore, MD; the Department of Internal Medicine (K.M., L.H., V.K., M.A., O.K.S.), University of Zambia School of Medicine, Lusaka, Zambia; the Department of Internal Medicine (L.H.), University of Maryland School of Medicine, Baltimore, MD; the Department of Pediatrics and Child Health, College of Medicine (M.M.), and the Department of Internal Medicine (J.M.), Queen Elizabeth Central Hospital, Blantyre, Malawi; the Neurology Unit, Department of Internal Medicine (E.O.N.), Federal Medical Center Owerri, Imo State, Nigeria; the Neurology Unit (T.L.), Department of Internal Medicine, Lagos University Teaching Hospital, Lagos State, Nigeria; the Neurology Unit, Department of Internal Medicine (C.B.M.), Jos University Teaching Hospital, Jos, Plateau State, Nigeria; the Division of Infectious Diseases & International Medicine, Department of Medicine (D.R.B.), University of Minnesota, Minneapolis; Epilepsy Division, Department of Neurology (G.L.B.), University of Rochester, NY; the Chikankata Epilepsy Care Team (G.L.B.), Mazabuka, Zambia; and the Global Neurology Program, Division of Neuroimmunology, Center for Virology and Vaccine Research, Department of Neurology (O.K.S.), Beth Israel Deaconess Medical Center, Boston, MA.

PMID: 25964478
PMCID: PMC4433455
DOI: 10.1212/WNL.0000000000001561

Lumbar puncture refusal in sub-Saharan Africa: A call for further understanding and intervention

Kiran T Thakur et al. Neurology. 2015.

. 2015 May 12;84(19):1988-90.

doi: 10.1212/WNL.0000000000001561.

Affiliations

¹ From the Division of Neuroinfectious Diseases and Neuroimmunology, Department of Neurology (K.T.T.), Johns Hopkins Hospital, Baltimore, MD; the Department of Internal Medicine (K.M., L.H., V.K., M.A., O.K.S.), University of Zambia School of Medicine, Lusaka, Zambia; the Department of Internal Medicine (L.H.), University of Maryland School of Medicine, Baltimore, MD; the Department of Pediatrics and Child Health, College of Medicine (M.M.), and the Department of Internal Medicine (J.M.), Queen Elizabeth Central Hospital, Blantyre, Malawi; the Neurology Unit, Department of Internal Medicine (E.O.N.), Federal Medical Center Owerri, Imo State, Nigeria; the Neurology Unit (T.L.), Department of Internal Medicine, Lagos University Teaching Hospital, Lagos State, Nigeria; the Neurology Unit, Department of Internal Medicine (C.B.M.), Jos University Teaching Hospital, Jos, Plateau State, Nigeria; the Division of Infectious Diseases & International Medicine, Department of Medicine (D.R.B.), University of Minnesota, Minneapolis; Epilepsy Division, Department of Neurology (G.L.B.), University of Rochester, NY; the Chikankata Epilepsy Care Team (G.L.B.), Mazabuka, Zambia; and the Global Neurology Program, Division of Neuroimmunology, Center for Virology and Vaccine Research, Department of Neurology (O.K.S.), Beth Israel Deaconess Medical Center, Boston, MA. kthakur1@jhmi.edu.
² From the Division of Neuroinfectious Diseases and Neuroimmunology, Department of Neurology (K.T.T.), Johns Hopkins Hospital, Baltimore, MD; the Department of Internal Medicine (K.M., L.H., V.K., M.A., O.K.S.), University of Zambia School of Medicine, Lusaka, Zambia; the Department of Internal Medicine (L.H.), University of Maryland School of Medicine, Baltimore, MD; the Department of Pediatrics and Child Health, College of Medicine (M.M.), and the Department of Internal Medicine (J.M.), Queen Elizabeth Central Hospital, Blantyre, Malawi; the Neurology Unit, Department of Internal Medicine (E.O.N.), Federal Medical Center Owerri, Imo State, Nigeria; the Neurology Unit (T.L.), Department of Internal Medicine, Lagos University Teaching Hospital, Lagos State, Nigeria; the Neurology Unit, Department of Internal Medicine (C.B.M.), Jos University Teaching Hospital, Jos, Plateau State, Nigeria; the Division of Infectious Diseases & International Medicine, Department of Medicine (D.R.B.), University of Minnesota, Minneapolis; Epilepsy Division, Department of Neurology (G.L.B.), University of Rochester, NY; the Chikankata Epilepsy Care Team (G.L.B.), Mazabuka, Zambia; and the Global Neurology Program, Division of Neuroimmunology, Center for Virology and Vaccine Research, Department of Neurology (O.K.S.), Beth Israel Deaconess Medical Center, Boston, MA.

PMID: 25964478
PMCID: PMC4433455
DOI: 10.1212/WNL.0000000000001561

No abstract available

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Figures

**Figure. Visual poster used in the Cryptococcal Optimal Antiretroviral Therapy Timing (COAT) trial for patient education regarding lumbar punctures**
Created by Kosuke Yasukawa. Reprinted with permission.

See this image and copyright information in PMC

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References

1. Wynter WE. Four cases of tubercular meningitis in which paracentesis of the theca vertebralis was performed for the relief of fluid pressure. Lancet 1891;1:981–982.
1. Bicanic T, Brouwer AE, Meintjes G, et al. Relationship of cerebrospinal fluid pressure, fungal burden and outcome in patients with cryptococcal meningitis undergoing serial lumbar punctures. AIDS 2009;23:701–706. - PubMed
1. Boulware DR, Meya DB, Muzoora C, et al. Timing of antiretroviral therapy after diagnosis of cryptococcal meningitis. N Engl J Med 2014;370:2487–2498. - PMC - PubMed
1. English M, Esamai F, Wasunna A, et al. Assessment of inpatient paediatric care in first referral level hospitals in 13 districts in Kenya. Lancet 2004;363:1948–1953. - PubMed
1. Korein J, Cravioto H, Leicach M. Reevaluation of lumbar puncture: a study of 129 patients with papilledema or intracranial hypertension. Neurology 1959;9:290–297. - PubMed

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[1] Wynter WE. Four cases of tubercular meningitis in which paracentesis of the theca vertebralis was performed for the relief of fluid pressure. Lancet 1891;1:981–982.

[2] Wynter WE. Four cases of tubercular meningitis in which paracentesis of the theca vertebralis was performed for the relief of fluid pressure. Lancet 1891;1:981–982.

[3] Bicanic T, Brouwer AE, Meintjes G, et al. Relationship of cerebrospinal fluid pressure, fungal burden and outcome in patients with cryptococcal meningitis undergoing serial lumbar punctures. AIDS 2009;23:701–706. - PubMed

[4] Bicanic T, Brouwer AE, Meintjes G, et al. Relationship of cerebrospinal fluid pressure, fungal burden and outcome in patients with cryptococcal meningitis undergoing serial lumbar punctures. AIDS 2009;23:701–706. - PubMed

[5] Boulware DR, Meya DB, Muzoora C, et al. Timing of antiretroviral therapy after diagnosis of cryptococcal meningitis. N Engl J Med 2014;370:2487–2498. - PMC - PubMed

[6] Boulware DR, Meya DB, Muzoora C, et al. Timing of antiretroviral therapy after diagnosis of cryptococcal meningitis. N Engl J Med 2014;370:2487–2498. - PMC - PubMed

[7] English M, Esamai F, Wasunna A, et al. Assessment of inpatient paediatric care in first referral level hospitals in 13 districts in Kenya. Lancet 2004;363:1948–1953. - PubMed

[8] English M, Esamai F, Wasunna A, et al. Assessment of inpatient paediatric care in first referral level hospitals in 13 districts in Kenya. Lancet 2004;363:1948–1953. - PubMed

[9] Korein J, Cravioto H, Leicach M. Reevaluation of lumbar puncture: a study of 129 patients with papilledema or intracranial hypertension. Neurology 1959;9:290–297. - PubMed

[10] Korein J, Cravioto H, Leicach M. Reevaluation of lumbar puncture: a study of 129 patients with papilledema or intracranial hypertension. Neurology 1959;9:290–297. - PubMed

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Lumbar puncture refusal in sub-Saharan Africa: A call for further understanding and intervention

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Lumbar puncture refusal in sub-Saharan Africa: A call for further understanding and intervention

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