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Clinical presentations, diagnosis, mortality and prognostic markers of tuberculous meningitis in Vietnamese children: a prospective descriptive study.
- Source :
-
BMC infectious diseases [BMC Infect Dis] 2016 Oct 18; Vol. 16 (1), pp. 573. Date of Electronic Publication: 2016 Oct 18. - Publication Year :
- 2016
-
Abstract
- Background: Tuberculous meningitis in adults is well characterized in Vietnam, but there are no data on the disease in children. We present a prospective descriptive study of Vietnamese children with TBM to define the presentation, course and characteristics associated with poor outcome.<br />Methods: A prospective descriptive study of 100 consecutively admitted children with TBM at Pham Ngoc Thach Hospital, Ho Chi Minh City. Cox and logistic regression were used to identify factors associated with risk of death and a combined endpoint of death or disability at treatment completion.<br />Results: The study enrolled from October 2009 to March 2011. Median age was 32.5 months; sex distribution was equal. Median duration of symptoms was 18.5 days and time from admission to treatment initiation was 11 days. Fifteen of 100 children died, 4 were lost to follow-up, and 27/81 (33 %) of survivors had intermediate or severe disability upon treatment completion. Microbiological confirmation of disease was made in 6 %. Baseline characteristics associated with death included convulsions (HR 3.46, 95CI 1.19-10.13, p = 0.02), decreased consciousness (HR 22.9, 95CI 3.01-174.3, p < 0.001), focal neurological deficits (HR 15.7, 95CI 1.67-2075, p = 0.01), Blantyre Coma Score (HR 3.75, 95CI 0.99-14.2, p < 0.001) and CSF protein, lactate and glucose levels. Neck stiffness, MRC grade (children aged >5 years) and hydrocephalus were also associated with the combined endpoint of death or disability.<br />Conclusions: Tuberculous meningitis in Vietnamese children has significant mortality and morbidity. There is significant delay in diagnosis; interventions that increase the speed of diagnosis and treatment initiation are likely to improve outcomes.
- Subjects :
- Adolescent
Child
Child, Preschool
Female
Humans
Hydrocephalus microbiology
Infant
Length of Stay
Logistic Models
Lost to Follow-Up
Male
Prognosis
Prospective Studies
Spinal Puncture
Treatment Outcome
Tuberculosis, Meningeal etiology
Vietnam
Tuberculosis, Meningeal diagnosis
Tuberculosis, Meningeal mortality
Subjects
Details
- Language :
- English
- ISSN :
- 1471-2334
- Volume :
- 16
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- BMC infectious diseases
- Publication Type :
- Academic Journal
- Accession number :
- 27756256
- Full Text :
- https://doi.org/10.1186/s12879-016-1923-2