Tuberculous Meningitis in Children: Treatment Outcomes at Discharge and Its Associated Factors in Eastern Ethiopia: A Five Years Retrospective Study

Figures & data

Table 1 Sociodemographic Characteristics of TBM Among Children Admitted and Treated in HFCSUH from 2017 to 2021 (N=121)

Variable	Response Categories	Frequency (n)	Percent (%)
Age	Less than 5 years	86	71.1
	> 5 years	35	28.9
Sex	Male	76	62.8
	Female	45	37.2
Residency	Urban	26	21.5
	Rural	95	78.5
TB contact history	Yes	82	67.8
	No	39	33.2
BCG vaccinated	Yes	30	24.8
	No	91	75.2
HIV infection	Yes	5	6.6
	No	116	93.4
Nutritional status	SAM	32	26.4
	MAM	18	14.9
	Underweight	7	5.8
	Well-nourished	64	52.9
History of comorbidity*	Yes	17	14.0
	No	104	86.0
Referral	Yes	99	81.8
	No	22	18.2
Duration of illness at admission	≤ 1 month	52	43.0
	> 1 month	66	57.0

Note: *Comorbidity (diabetes Mellitus, Chronic Liver Disease, HIV and measles).

Abbreviations: SAM, Severe Acute Malnutrition; MAM, Moderate Acute Malnutrition.

Table 2 Clinical Features of TBM Among Children Admitted and Treated in HFCSUH from 2017 to 2021 (N=121)

Variables	Categories	Frequency (n)	Percent (%)
Fever	Yes	115	95.0
Cough	Yes	109	90.1
Weight loss	Yes	100	82.6
Altered mental status	Yes	100	82.6
Vomiting	Yes	83	68.6
Seizure	Yes	71	58.7
Headache	Yes	52	57.8
Raised intracranial pressure	Yes	68	56.2
Neck stiffness	Yes	45	37.7
Coma at admission	Yes	43	35.5
Sign of brainstem dysfunction	Yes	52	43.0
Motor deficit	Yes	34	28.1
Cranial nerve palsy	Yes	18	14.9
Sign of brain herniation	Yes	17	14.0
Hydrocephalus	Yes	36	29.8
Brain abscess	Yes	13	10.7
Case definition of TBM	Definitive	12	9.9
	Probable	87	71.9
	Possible	22	18.2
Stage of TBM	Stage I	17	14.0
	Stage II	46	38.1
	Stage III	58	47.9

Table 3 Investigation Findings of TBM Among Children Admitted and Treated in HFCSUH from 2017 to 2021 (N=121)

Type Investigations	Findings	Frequency (n)	Percent (%)
CSF (N=48)	WBC count > 5/uL	41	85.0
	Lymphocyte ≥ 50%	40	85.0
	Protein ≥ 100 mg/dL	43	93.0
	Glucose ≤ 40 mg/dL	28	60.0
	MTB on Xpert MTB/RIF assay (N=16)	12	75.0
CT scan (N=49)	Hydrocephalus	36	73.5
	Brain abscess	13	26.5
	Infarction	12	24.5
	Basal meningeal enhancement	5	10.2
	Pre-contrast basal hyper-density	1	2.0
MTB detected from gastric aspiration (N=117)	Yes	80	68.4
CXR suggestive for PTB (N=119)	Yes	102	85.7

Figure 1 Tuberculous meningitis treatment outcome at discharge among children admitted and treated in HFCSUH from 2017 to 2021 (N=121).

Table 4 Factors associated with treatment outcomes of TBM at discharge among children who were admitted at HFCSUH from 2017 to 2021 (N=121)

Variables	Categories	Clinical Outcome		COR (95%CI)	AOR (95%CI)	p-value
		Poor	Good
Sex	Male	52	24	2.07 (0.97-4.43)	1.42 (0.53-3.79)	0.490
	Female	23	22	1.00	1.00
Place of residency	Urban	10	7	0.86 (0.30-2.43)	1.64 (0.34-6.84)	0.496
	Rural	65	39	1.00	1.00
Stage of TBM at admission	Stage III	49	9	7.75 (3.25-18.49)	5.29 (1.88-14.84)	0.002
	Stage II or I	26	37	1.00	1.00
Nutritional status	Malnourished	47	10	6.04 (2.60-14.03)	2.87 (1.04-7.94)	0.042
	Well nourished	28	36	1.00	1.00
Hydrocephalus on CT scan	Yes	31	5	5.78 (2.05-16.28)	3.78 (1.08-13.34)	0.037
	No	44	41	1.00	1.00
duration of illness	≤ 1 month	23	32	0.19(0.09-0.43)	0.33 (0.15-0.86)	0.024
	> 1 month	52	14	1.00	1.00

Abbreviations: TBM, tuberculosis meningitis; AOR, adjusted odds ratio; AOR, crude odds ratio; CI, confidence interval.