RT Journal Article
T1 Treatment and Outcome in Children With Tuberculous Meningitis: A Multicenter Pediatric Tuberculosis Network European Trials Group Study.
A1 Thee, Stephanie
A1 Basu Roy, Robindra
A1 Blázquez-Gamero, Daniel
A1 Falcón-Neyra, Lola
A1 Neth, Olaf
A1 Noguera-Julian, Antoni
A1 Lillo, Cristina
A1 Galli, Luisa
A1 Venturini, Elisabetta
A1 Buonsenso, Danilo
A1 Götzinger, Florian
A1 Martinez-Alier, Nuria
A1 Velizarova, Svetlana
A1 Brinkmann, Folke
A1 Welch, Steven B
A1 Tsolia, Maria
A1 Santiago-Garcia, Begoña
A1 Schilling, Ralph
A1 Tebruegge, Marc
A1 Krüger, Renate
A1 ptbnet TB Meningitis Study Group, 
K1 children
K1 dosing
K1 outcome
K1 treatment
K1 tuberculous meningitis
AB Currently, data on treatment, outcome, and prognostic factors in children with tuberculous meningitis (TBM) in Europe are limited. To date, most existing data on TBM originate from adult studies, or studies conducted in low-resource settings. We designed a multicenter, retrospective study involving 27 pediatric healthcare institutions in 9 European countries via an established pediatric TB research network, before and after the 2014 revision of World Health Organization (WHO) dosing recommendations. Of 118 children, 39 (33.1%) had TBM grade 1, 68 (57.6%) grade 2, and 11 (9.3%) grade 3. Fifty-eight (49.1%) children received a standard 4-drug treatment regimen; other commonly used drugs included streptomycin, prothionamide, and amikacin. Almost half of the patients (48.3%; 56/116) were admitted to intensive care unit, with a median stay of 10 (interquartile range [IQR] 4.5-21.0) days. Of 104 children with complete outcome data, 9.6% (10/104) died, and only 47.1% (49/104) recovered fully. Main long-term sequelae included spasticity of 1 or more limbs and developmental delay both in 19.2% (20/104), and seizure disorder in 17.3% (18/104). Multivariate regression analyses identified microbiological confirmation of TBM, the need for neurosurgical intervention, and mechanical ventilation as risk factors for unfavorable outcome. There was considerable heterogeneity in the use of TB drugs in this cohort. Despite few children presenting with advanced disease and the study being conducted in a high-resource setting, morbidity and mortality were high. Several risk factors for poor outcome were identified, which may aid prognostic predictions in children with TBM in the future.
YR 2022
FD 2022
LK https://hdl.handle.net/10668/27635
UL https://hdl.handle.net/10668/27635
LA en
DS RISalud
RD Apr 5, 2025