Outcome of children with tuberculous meningitis: a prospective study from a tertiary care centre in Southern India
Keywords:Behavioural abnormalities, Childhood TB, Hydrocephalus, Tuberculosis, TB Meningitis
Background: TB Meningitis is one of the most serious forms of Tuberculosis. Objective of the current study was to assess the clinical outcome of children presented with TB Meningitis in a tertiary care centre in southern India by following them up and assess their present state in terms of neurological deficits, hearing and visual deficits, learning difficulties and day to day performances.
Methods: Children between 0 - 15 years diagnosed to have TB meningitis in a 2700 bedded hospital in Tamilnadu, India, during the time period 1999-2003 were identified through medical records. These children were called back after 2 to 7 years and health status in terms of neurological deficits, learning deficits, persisting seizures and day to day performance, hearing, ophthalmologic assessment and Intelligence quotient assessment were assessed.
Results: Nearly one third of the children with TB meningitis showed complete recovery. One third died and another one third had some disability. Major problem (46%) encountered in TB meningitis survivors was behavioural problems; the commonest being hyperactivity. Ten out of 27 children had poor scholastic performances, six had neurological deficits and four had seizure disorders. Of 17 children assessed, two had hearing impairment and five had visual impairment. All children with hydrocephalus and were shunted within five days had fully recovered. Of the children shunted later, 9 children (60%) had some sequelae.Conclusions: Childhood TB meningitis has very poor outcomes. Poor prognosis and difficult early diagnosis emphasise the importance of preventive therapy for child contacts of patients with tuberculosis.