Volume 28, Number 3—March 2022
Treatment Outcomes of Childhood Tuberculous Meningitis in a Real-World Retrospective Cohort, Bandung, Indonesia
|Variable||Died‡§||Alive‡||Crude OR (95% CI)||p value||aOR (95% CI)||p value|
|Age group, y|
|<2||3 (16.7)||26 (28.6)||0.65 (0.15–2.86)||0.573||0.13 (0.01–1.12)||0.064|
|2–4||6 (33.3)||9 (9.9)||3.78 (0.98–14.56)||0.054||1.60 (0.26–9.86)||0.610|
|5–9||3 (16.7)||22 (24.2)||0.77 (0.17–3.41)||0.734||0.23 (0.03–1.75)||0.156|
|M||10 (55.6)||39 (42.9)||1.67 (0.60–4.61)||0.325||3.43 (0.76–15.45)||0.109|
|Stage I or II||7 (38.9)||67 (73.6)||Referent||Referent|
|Known BCG vaccination|
|No||7 (38.9)||15 (16.5)||3.22 (1.08–9.66)||0.037||5.38 (1.07–27.07)||0.041|
|Hydrocephalus on CT|
|No||3 (16.7)||66 (72.5)||Referent||Referent|
|Yes||13 (72.2)||23 (25.3)||12.43 (3.25–47.59)||<0.001||18.97 (2.68–134.38)||0.003|
|Tuberculoma on CT#|
|No||12 (66.7)||85 (93.4)||Referent||Referent|
|No||10 (55.6)||76 (83.5)||Referent||Referent|
|Yes||8 (44.4)||15 (16.5)||4.05 (1.37–11.96)||0.011||4.79 (0.96–24.05)||0.057|
*Data are no. (%) except as indicated. aOR, adjusted odds ratio; BCG, bacillus Calmette-Guérin; CT, computed tomography; GCS, Glasgow Coma Scale; TBM, tuberculous meningitis; TST, tuberculin skin test. †The goodness-of-fit of the model using Hosmer-Lemeshow test was p = 0.877. The performance of the model using the area under the receiver operating characteristic curve was 0.91 (95% CI 0.85–0.97). ‡Including patients who were tracked until death or treatment completion, and excluding patients who were lost to follow-up and with unknown treatment outcomes. §Positive TST and motor disorders were associated with higher odds of postdischarge death in univariate analysis but did not remain significant in multivariate analysis. Signs of raised intracranial pressure with hydrocephalus as well as GCS score with TBM staging had the likelihood of collinearity; therefore, only hydrocephalus and TBM staging were included in the final multivariate model. In our subgroup analysis among children aged <5 y, no additional independent predictors of postdischarge death were observed. ¶Stage I TBM was defined as GCS of 15 with no focal neurologic signs, stage II TBM as GCS of 11–14 or 15 with focal neurologic signs, and stage III TBM as GCS ≤10 (20). Patients with stages I and II TBM were combined in the analysis because there were no patients with TBM stage I died after hospital discharge. #Because of the redundancy with the variable “unknown status of hydrocephalus,” the degree of freedom for the variable “unknown status of tuberculoma” was reduced.
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1These first authors contributed equally to this article.