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Long-term status of children treated for tuberculous meningitis in south India
P Ramachandran1, M Duraipandian, A M Reetha
1Tuberculosis Research Centre (Indian Council of Medical Research), Chetput, Madras.
Insights
Long-term follow-up of children recovering from tuberculous meningitis shows that 12-month treatment may be adequate. Most survivors experienced neurological sequelae, with 47% making a full recovery.
Area of Science:
- Neurology
- Infectious Diseases
- Pediatrics
Background:
- Tuberculous meningitis (TBM) is a severe infection with significant mortality and morbidity.
- Long-term outcomes for pediatric TBM survivors are crucial for understanding disease impact and treatment efficacy.
Purpose of the Study:
- To evaluate the long-term neurological sequelae and recovery in children treated for tuberculous meningitis.
- To assess the adequacy of a 12-month treatment regimen for TBM.
Main Methods:
- A long-term follow-up study was conducted on 119 children who had recovered from tuberculous meningitis.
- Data collected over 4.5 to 8 years included mortality, neurological deficits, and treatment outcomes.
Main Results:
- Of 100 patients with available information, 47% achieved complete recovery, while 53% had neurological sequelae (2% severe, 39% moderate, 12% mild).
- Mortality rate was 17% (10% due to TBM sequelae, 7% due to other causes).
- No relapses were observed during the follow-up period.
Conclusions:
- A 12-month treatment course for tuberculous meningitis may be sufficient to prevent relapses.
- Neurological sequelae are common in pediatric TBM survivors, necessitating ongoing management and rehabilitation strategies.
Abstract:
This report gives the findings of long-term follow-up (4 1/2-8 years) of 119 children who recovered from tuberculous meningitis. Of these, 17 patients died (10 due to severe tuberculous meningitis sequelae and 7 due to non-tuberculous causes) and 2 could not be traced. Of the remaining 100 patients for whom information was available, 47 (47%) made a complete recovery, while 53 (53%) had neurological sequelae--2 (2%) had severe, 39 (39%) moderate and 12 (12%) mild sequelae. There were no relapses during the 4 1/2-8 year period, indicating that regular treatment for 12 months may be adequate.