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Treatment Outcomes of Childhood Tuberculous Meningitis in a Real-World Retrospective Cohort, Bandung, Indonesia

We retrospectively evaluated clinical features and outcomes in children treated for tuberculous meningitis (TBM) at Hasan Sadikin Hospital, Bandung, Indonesia, during 2011–2020. Among 283 patients, 153 (54.1%) were <5 years of age, and 226 (79.9%) had stage II or III TBM. Predictors of in-hospita...

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Autores principales: Nataprawira, Heda M., Gafar, Fajri, Risan, Nelly A., Wulandari, Diah A., Sudarwati, Sri, Marais, Ben J., Stevens, Jasper, Alffenaar, Jan-Willem C., Ruslami, Rovina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Centers for Disease Control and Prevention 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8888221/
https://www.ncbi.nlm.nih.gov/pubmed/35202524
http://dx.doi.org/10.3201/eid2803.212230
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author Nataprawira, Heda M.
Gafar, Fajri
Risan, Nelly A.
Wulandari, Diah A.
Sudarwati, Sri
Marais, Ben J.
Stevens, Jasper
Alffenaar, Jan-Willem C.
Ruslami, Rovina
author_facet Nataprawira, Heda M.
Gafar, Fajri
Risan, Nelly A.
Wulandari, Diah A.
Sudarwati, Sri
Marais, Ben J.
Stevens, Jasper
Alffenaar, Jan-Willem C.
Ruslami, Rovina
author_sort Nataprawira, Heda M.
collection PubMed
description We retrospectively evaluated clinical features and outcomes in children treated for tuberculous meningitis (TBM) at Hasan Sadikin Hospital, Bandung, Indonesia, during 2011–2020. Among 283 patients, 153 (54.1%) were <5 years of age, and 226 (79.9%) had stage II or III TBM. Predictors of in-hospital death (n = 44 [15.5%]) were stage III TBM, hydrocephalus, male sex, low-income parents, seizures at admission, and lack of bacillus Calmette-Guérin vaccination. Predictors of postdischarge death (n = 18 [6.4%]) were hydrocephalus, tuberculoma, and lack of bacillus Calmette-Guérin vaccination. At treatment completion, 91 (32.1%) patients were documented to have survived, of whom 33 (36.3%) had severe neurologic sequelae and 118 (41.7%) had unknown outcomes. Predictors of severe neurologic sequelae were baseline temperature >38°C, stage III TBM, and baseline motor deficit. Despite treatment, childhood TBM in Indonesia causes substantial neurologic sequelae and death, highlighting the importance of improved early diagnosis, better tuberculosis prevention, and optimized TBM management strategies.
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spelling pubmed-88882212022-03-02 Treatment Outcomes of Childhood Tuberculous Meningitis in a Real-World Retrospective Cohort, Bandung, Indonesia Nataprawira, Heda M. Gafar, Fajri Risan, Nelly A. Wulandari, Diah A. Sudarwati, Sri Marais, Ben J. Stevens, Jasper Alffenaar, Jan-Willem C. Ruslami, Rovina Emerg Infect Dis Research We retrospectively evaluated clinical features and outcomes in children treated for tuberculous meningitis (TBM) at Hasan Sadikin Hospital, Bandung, Indonesia, during 2011–2020. Among 283 patients, 153 (54.1%) were <5 years of age, and 226 (79.9%) had stage II or III TBM. Predictors of in-hospital death (n = 44 [15.5%]) were stage III TBM, hydrocephalus, male sex, low-income parents, seizures at admission, and lack of bacillus Calmette-Guérin vaccination. Predictors of postdischarge death (n = 18 [6.4%]) were hydrocephalus, tuberculoma, and lack of bacillus Calmette-Guérin vaccination. At treatment completion, 91 (32.1%) patients were documented to have survived, of whom 33 (36.3%) had severe neurologic sequelae and 118 (41.7%) had unknown outcomes. Predictors of severe neurologic sequelae were baseline temperature >38°C, stage III TBM, and baseline motor deficit. Despite treatment, childhood TBM in Indonesia causes substantial neurologic sequelae and death, highlighting the importance of improved early diagnosis, better tuberculosis prevention, and optimized TBM management strategies. Centers for Disease Control and Prevention 2022-03 /pmc/articles/PMC8888221/ /pubmed/35202524 http://dx.doi.org/10.3201/eid2803.212230 Text en https://creativecommons.org/licenses/by/4.0/Emerging Infectious Diseases is a publication of the U.S. Government. This publication is in the public domain and is therefore without copyright. All text from this work may be reprinted freely. Use of these materials should be properly cited.
spellingShingle Research
Nataprawira, Heda M.
Gafar, Fajri
Risan, Nelly A.
Wulandari, Diah A.
Sudarwati, Sri
Marais, Ben J.
Stevens, Jasper
Alffenaar, Jan-Willem C.
Ruslami, Rovina
Treatment Outcomes of Childhood Tuberculous Meningitis in a Real-World Retrospective Cohort, Bandung, Indonesia
title Treatment Outcomes of Childhood Tuberculous Meningitis in a Real-World Retrospective Cohort, Bandung, Indonesia
title_full Treatment Outcomes of Childhood Tuberculous Meningitis in a Real-World Retrospective Cohort, Bandung, Indonesia
title_fullStr Treatment Outcomes of Childhood Tuberculous Meningitis in a Real-World Retrospective Cohort, Bandung, Indonesia
title_full_unstemmed Treatment Outcomes of Childhood Tuberculous Meningitis in a Real-World Retrospective Cohort, Bandung, Indonesia
title_short Treatment Outcomes of Childhood Tuberculous Meningitis in a Real-World Retrospective Cohort, Bandung, Indonesia
title_sort treatment outcomes of childhood tuberculous meningitis in a real-world retrospective cohort, bandung, indonesia
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8888221/
https://www.ncbi.nlm.nih.gov/pubmed/35202524
http://dx.doi.org/10.3201/eid2803.212230
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