Table of Contents Author Guidelines Submit a Manuscript
BioMed Research International
Volume 2017, Article ID 9316589, 6 pages
https://doi.org/10.1155/2017/9316589
Research Article

Clinical Features and Outcome in Adult Cases of Tuberculous Meningitis in Tertiary Care Hospital in Antananarivo, Madagascar

1Service des Maladies Infectieuses, Hôpital Universitaire Joseph Raseta Befelatanana, Antananarivo, Madagascar
2Service des Maladies Infectieuses, CHU Tambohobe, Fianarantsoa, Madagascar
3Université de Fianarantsoa, Fianarantsoa, Madagascar
4Programme National de Lutte contre la Tuberculose (PNLT), Ministère de la Santé Publique, Antananarivo, Madagascar

Correspondence should be addressed to Mihaja Raberahona; moc.liamg@anoharebar

Received 10 December 2016; Accepted 5 March 2017; Published 15 March 2017

Academic Editor: Valeria Rolla

Copyright © 2017 Mihaja Raberahona et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose. We aimed to describe and to assess prognosis factors in tuberculous meningitis in adult patients. Methods. We performed a retrospective study of case records of adult patients. Patients classified as definite, probable, or possible tuberculous meningitis according to standardized definition criteria were included and assessed in the study. Results. Seventy-five patients were included in the study. Tuberculous meningitis was classified as definite in 8 (10.7%), probable in 44 (58.7%), and possible in 23 patients (30.6%). HIV was found in 3% of patients. Patients were in advanced stages at admission in 82.7%. Median duration of symptoms prior to admission was 3 weeks (IQR: 2–5). Median time to diagnosis following admission was 5 days (IQR: 3–8). Median CSF WCC was 75 per mm3 with lymphocytic predominance in 38 cases (52.8%). Median CSF glucose level was 1.48 mmol/L and median CSF protein level was 1 g/L. Mortality rate was 28%. Age ≥ 35 years (aOR: 4.06; 95% CI: 1.16–14.26) and coma (aOR: 12.98; 95% CI: 1.13–149.16) predicted inpatient mortality. Conclusion. Most of the patients experienced more than 3 weeks of diagnostic delay prior to admission. Mortality was high and occurred early after admission. Age and coma were identified as independent prognosis factors.