CLINICAL PROFILE OF CHILDREN TREATED FOR TUBERCULOUS MENINGITIS AT ST. PAUL’S AND YEKATIT 12 MEMORIAL HOSPITALS IN ADDIS ABABA: A THREE YEAR RETROSPECTIVE CROSS-SECTIONAL ANALYSIS

Abstract

Background: Tuberculous Meningitis (TBM) is the most severe form of tuberculosis in children and incurs high mortality and morbidity. Globally the incidence of tuberculous meningitis is not exactly known especially in developing countries [2]. Roughly about 1% of all TB diseases develop tuberculous meningitis [6].

Methodology: This study employed a retrospective cross-sectional analysis of the archives of pediatrics patients admitted to St. Paul Hospital Mellinium Medical College (SPHMMC) and Yekatit 12 Hospital Medical College with the assessment of TBM during the time from July 1, 2014-June 30, 2017GC.

Results: In this study 70 patients files with the assessment of TBM was collected from the record room and 63 of these fulfilled the diagnostic criteria to be included in the final analysis. According to consensus case definition 1 (1.6%) case was definite, 22(34.9%) cases were probable and 40(63.5%) cases were possible. Nine of them (14.3%) died within the hospital, 29(46%) survived with sequel and 19(30.2%) survived with no apparent recorded sequel. Forty eight (76.2%) of patients had brain imaging, of which (93.8%) of them had recorded abnormalities. The commonest abnormality was hydrocephalus 24(50%) and basal meningeal enhancement 22(45.8%). Gene Xpert MTB detection rate was about 33.3%.

Conclusion: Tuberculous meningitis continued to be a cause of significant sequel and mortality in children. Stage of TBM at presentation, increased intracranial pressure (ICP) and altered mentation on presentation has statically significant association with sequel on discharge while altered mentation on presentation has statically significant association with mortality