Presentation and Outcome of Tuberculous Meningitis among Children: Experiences from a Tertiary Children’s Hospital
Open Access
- 11 March 2014
- journal article
- Published by African Journals Online (AJOL) in African Health Sciences
- Vol. 14 (1), 143-9
- https://doi.org/10.4314/ahs.v14i1.22
Abstract
Background: Diagnosis of tuberculous meningitis (TBM) is complicated and outcome is poor especially in resource limited settings. Early diagnosis and prompt treatment are vital in effective treatment. We set out to describe experiences in the management and immediate outcome of TBM a tertiary-level children’s hospital in a high HIV and tuberculosis co-infection setting. Methods: This retrospective study included children who were diagnosed with TBM in the year 2009. A pre-coded questionnaire was used to extract data on presentation, diagnostics, treatment and outcome at the time of hospital discharge. Data was analyzed using STATA statistical package (StataCorp, Version 11). Results: Of the 40 children diagnosed with TBM, 6 (15%) had definitive TBM, 17 (42.5%) had probable TBM and 17 (42.5%) had possible TBM. The cerebrospinal fluid (CSF) chemistry and cells were abnormal in 39/40 (98%). Mantoux test was reactive in 16/29 (55%) and 17/30 (57%) had Chest X-rays suggestive of tuberculosis. Only 3/21 (14%) had positive sputum tuberculosis culture and 89% (32/36) had neuro-imaging abnormalities. Outcome at discharge was; 8% died, 49% improved with neurological sequelae and 43% improved without sequelae. Having TBM stage 3 at admission was associated with mortality (p=0.001). Conclusions: Most children had early diagnosis of TBM and mortality was lower than previous studies. We recommend a larger prospective study to further understand the outcome of TBM. Keywords: Tuberculous meningitis, children, presentation, outcome, Africa African Health sciences Vol 14 No. 1 March 2014Keywords
This publication has 23 references indexed in Scilit:
- Evaluation of the Xpert MTB/RIF test for the diagnosis of childhood pulmonary tuberculosis in Uganda: a cross-sectional diagnostic studyBMC Infectious Diseases, 2013
- Can a Simple Flotation Method Lower the Limit of Detection of Mycobacterium tuberculosis in Extrapulmonary Samples Analyzed by the GeneXpert MTB/RIF Assay?Journal of Clinical Microbiology, 2012
- Tuberculous meningitis in Denmark: a review of 50 casesBMC Infectious Diseases, 2011
- Multidrug-Resistant Tuberculous Meningitis in Children in Durban, South AfricaThe Pediatric Infectious Disease Journal, 2006
- Prognostic Factors in Childhood Tuberculous MeningitisJournal of Tropical Pediatrics, 2002
- Tuberculous Meningitis in Children: Clinical Features and Outcome in 40 CasesScandinavian Journal of Infectious Diseases, 2000
- Fatores prognósticos de letalidade na meningoencefalite tuberculosaArquivos de Neuro-Psiquiatria, 1998
- Tuberculous Meningitis at a Large Inner-City Medical CenterThe American Journal of the Medical Sciences, 1997
- Pediatric meningitis in the western Cape Province of South AfricaJournal of Tropical Pediatrics, 1996
- New Approaches to the Rapid Diagnosis of Tuberculous MeningitisThe Journal of Infectious Diseases, 1987