Thesis (MMed)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: BACKGROUND: Tuberculous meningitis (TBM) research remains important but
obtaining adequate sample sizes of microbiologically-confirmed TBM cases is difficult,
therefore clinical cases of TBM need to be included. A uniform research case definition
for TBM was developed to assist diagnostic standardization.
METHODS: Our study evaluated the proposed uniform research case definition in a
group of children diagnosed with TBM. A subgroup of 66 children with cultureconfirmed
TBM was compared to culture-confirmed bacterial meningitis controls.
RESULTS: The uniform case definition was applied to 554 TBM patients. Sixty-six
(11.9%) patients had definite TBM, 408 (73.6%) had probable TBM and 72 (13.0%) had
possible TBM. Symptom duration >5 days, weight loss or persistent cough >2 weeks,
recent TB contact, focal neurological deficit, clear cerebrospinal fluid (CSF) appearance
and basal meningeal enhancement predicted TBM when compared to definite bacterial
meningitis with a sensitivity and specificity of 97.0% and 93.7%, respectively. When
using a probable TBM score as the diagnostic measure, sensitivity was 86% and
specificity was 100%. When using a possible TBM score as the diagnostic measure,
sensitivity was 100% but specificity was 56%.
CONCLUSION: The uniform research case definition for TBM performed well when
using a probable TBM score as the diagnostic marker. A regression model also
differentiated TBM from bacterial meningitis with good accuracy, but caution is needed
in its application to early TBM.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:sun/oai:scholar.sun.ac.za:10019.1/86775 |
| Date | 04 1900 |
| Creators | Wessels, Marie |
| Contributors | Solomons, Regan Shane, Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Paediatrics and Child Health. |
| Publisher | Stellenbosch : Stellenbosch University |
| Source Sets | South African National ETD Portal |
| Language | en_ZA |
| Detected Language | English |
| Type | Thesis |
| Format | 21 pages |
| Rights | Stellenbosch University |
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