Clinical indicators associated with tuberculous meningitis using multiple correspondence analysis

Area of Science:

• Infectious Diseases
• Neurology
• Public Health

Background:

• Tuberculous meningitis (TBM) is a severe form of tuberculosis with high mortality.
• Early diagnosis is challenging, especially in resource-limited settings.

Purpose of the Study:

• To identify clinical indicators for early diagnosis of microbiologically confirmed TBM.
• To aid clinicians in high-incidence areas with limited diagnostic capacity.

Main Methods:

• Retrospective cohort analysis of 146 TBM cases.
• Cerebrospinal fluid (CSF) culture and Xpert testing.
• Multiple correspondence analysis (MCA) for indicator identification.

Main Results:

• 80 out of 146 TBM cases were microbiologically confirmed.
• Key indicators for confirmed TBM include neck stiffness, low serum sodium, low CSF glucose and chloride, and HIV positivity.
• Hypertension and pulmonary TB were associated with unconfirmed TBM.

Conclusions:

• Identified clinical indicators can assist in the empirical diagnosis of TBM.
• Abnormal indicators increase the likelihood of detecting microbial evidence in CSF.