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Tuberculous meningitis in children in the Western Cape. Epidemiology and outcome
Insights
Tuberculous meningitis in children is common, with high rates of disability and death. Early diagnosis and treatment are crucial for better outcomes in pediatric tuberculous meningitis cases.
Area of Science:
- Pediatrics
- Infectious Diseases
- Epidemiology
Background:
- Tuberculous meningitis (TBM) poses a significant global health challenge, particularly in pediatric populations.
- Limited data exists on the epidemiological trends and clinical outcomes of TBM in specific regions.
Purpose of the Study:
- To determine the incidence of tuberculous meningitis in children.
- To analyze the stage of disease at presentation and its association with outcomes.
- To report on the morbidity and mortality rates associated with pediatric TBM.
Main Methods:
- Retrospective analysis of hospital records and local authority notifications.
- Inclusion of pediatric cases (0-14 years) over a 3-year period.
- Calculation of age-specific incidence rates.
Main Results:
- 185 cases of TBM were recorded over 3 years.
- The age-specific incidence was 7.5/100,000 for children aged 0-14 years.
- Only 28 cases presented with early-stage disease; young age and late presentation correlated with poor outcomes.
Conclusions:
- Pediatric tuberculous meningitis has a high incidence and severe consequences.
- Late diagnosis significantly contributes to poor prognosis, high mortality (24%), and substantial long-term disability (nearly 50%).
- Emphasizes the urgent need for early detection and intervention strategies for TBM in children.
Abstract:
The incidence of tuberculous meningitis in children was determined using hospital records as well as local authority notifications. One hundred and eighty-five cases occurred over a 3-year period. The age-specific incidence in the 0-14-year-old group was 7,5/100 000. In only 28 cases was the disease at an early stage when treatment was commenced. Young age and late-stage disease at presentation were associated with a poor outcome. The associated morbidity and mortality rates were high; the mortality rate was 24%, and nearly 50% of patients were left with a residual disability.