[TUBERCULOUS MENINGITIS IN ARMENIA: EPIDEMIOLOGY, CLINICAL PATTERN, AND OUTCOMES]

The authors studied statistical data on the trend in the incidence of tuberculous meningitis (TM) in the Republic of Armenia over 16 years (1992-2007) by two 8-year periods: namely, the data on the gender-, age-related, clinical pattern, and the outcomes of the disease in 74 patients treated in the pediatric and extrapulmonary units of the republican tuberculosis dispensary in 1998 to 2007. There was a considerable rise in the incidence of TM in adults in the second period and its decrease in children (by 1.9 times). The total number of the patients was 131 (66 and 65 in the first and second periods, respectively) per 105 population; the rate increased from 0.2 to 0.4 (i.e. 2-fold) in 2007. There was a preponderance of males (80%) among the adults and girls (69%) among the children. TM was prevalent in the prepubertal (7-13 years) and early (0-3 years) age groups among the children and in the old (36-65 years) age one. Clinically, meningoencephalitis was observed in 54.1% of cases, more frequently in the children (65.6%) than in the adults (48.9%). TM concurrent with other forms of tuberculosis was seen in 51.5%, more commonly in the children (65.6%) than in the adults (48.9%). Out of the concurrent lesions, military tuberculosis and generalized forms were predominant in the children and adults, respectively Mortality was 28.4% (21 dead patients). Of the deceased, 13 (61.9%) patients died within the first 24 hour and the first month after admission. The principal cause of death was late detection of the disease. In children, the aggravating factors were also none or inefficacious vaccination at birth, as well as intrafamily contact.