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Volume 28, Number 3—March 2022

Treatment Outcomes of Childhood Tuberculous Meningitis in a Real-World Retrospective Cohort, Bandung, Indonesia

Heda M. Nataprawira1, Fajri Gafar1Comments to Author , Nelly A. Risan, Diah A. Wulandari, Sri Sudarwati, Ben J. Marais, Jasper Stevens, Jan-Willem C. Alffenaar, and Rovina Ruslami
Author affiliations: Hasan Sadikin Hospital, Bandung, Indonesia (H.M. Nataprawira, N.A. Risan, D.A. Wulandari, S. Sudarwati); Universitas Padjadjaran, Bandung, Indonesia (H.M. Nataprawira, N.A. Risan, D.A. Wulandari, S. Sudarwati, R. Ruslami); University of Groningen, Groningen, the Netherlands (F. Gafar, J. Stevens); Children’s Hospital at Westmead, Sydney, New South Wales, Australia (B.J. Marais); University of Sydney, Sydney (B.J. Marais, J.-W.C. Alffenaar); Westmead Hospital, Sydney (J.-W.C. Alffenaar)

Main Article

Table 3

Hospitalization and end of treatment outcome, stratified by disease staging, in children with tuberculous meningitis treated at Hasan Sadikin Hospital, Bandung, Indonesia, 2011–2020*

Variable Total Stage I† Stage II† Stage III†
Outcome of hospitalization‡
Cases, no. 283 57 131 95
Recovered 231 (81.6) 54 (94.7) 111 (84.7) 66 (69.5)
Not recovered 8 (2.8) 1 (1.8) 5 (3.8) 2 (2.1)
44 (15.5)
2 (3.5)§
15 (11.5)
27 (28.4)
Length of hospital stay, d, median (IQR)
10 (7–17)
9 (7–14)
10 (7–14)
15 (8–25)
Time to death, d, median (IQR)
7 (3–13)
6 (2–8)
8 (3–16)
Outcome at treatment completion‡#
Cases, no. 272 56 122 94
Completed treatment 91 (33.5) 22 (39.3) 45 (36.9) 24 (25.5)
Without neurologic sequelae** 58 (63.7) 17 (77.3) 31 (68.9) 10 (41.7)
With neurologic sequelae** 33 (36.3) 5 (22.7) 14 (31.1) 14 (58.3)
Died 62 (22.8) 2 (3.6) 22 (18.0) 38 (40.4)
Died after hospital discharge 18 (6.6) 0 (0.0) 7 (5.7) 11 (11.7)
Lost to follow-up 1 (0.4) 0 (0.0) 1 (0.8) 0 (0.0)
Unknown treatment outcome 118 (43.4) 32 (57.1) 54 (44.3) 32 (34.0)

*Values are no. (%) except as indicated. IQR, interquartile rage. †Stage I was defined as Glasgow Coma Scale (GCS) of 15 with no focal neurologic signs, stage II as GCS of 11–14 or 15 with focal neurologic signs, and stage III as GCS ≤10 (20). ‡On hospital discharge, recovering patients were those who had clinical improvement (with or without disability), whereas non-recovering patients were those who had persistent vegetative state or discharged against medical advice. Treatment completion included patients who completed 12 mo of TBM therapy. Lost to follow-up included patients who stopped treatment for two consecutive months or more. Unknown treatment outcome included patients who were transferred back to regional public hospitals or community health clinics for follow-up after discharge. Neurologic sequelae were defined as any motor, hearing, visual, or neurodevelopmental impairment that appeared during the illness and persisted through treatment completion. §The causes of death in two patients with stage I TBM were hospital acquired pneumonia + thalassemia major (n = 1), and intracranial metastases of Burkitt lymphoma + increased intracranial pressure (n = 1). ¶Minimum–maximum range. #Excluding 11 patients who were still in ongoing treatment. **Percentages were calculated only in patients who completed 12 mo of treatment.

Main Article

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Main Article

1These first authors contributed equally to this article.

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