Factors Related to the Diagnosis of Tuberculosis Meningitis in Children at the National Children's Hospital from 2019 to 2024

Abstract

Abstract: Objective: Some factors related to the diagnosis of tuberculous meningitis at the National Children's Hospital (2019 - 2024). Subjects and methods: Cross-sectional descriptive study of 50 children from 1 month to 15 years old diagnosed and treated for tuberculous meningitis at the Center for Tropical Diseases, National Children's Hospital. Results: There were 50 patients with tuberculosis meningitis in nearly 6 years from January 2019 to October 2024: the average time of diagnosis from the onset of symptoms was 19 days, the earliest was 4 days and the latest was 56 days; the median time of treatment at a medical facility was 8 days. The majority (68% of patients) were diagnosed with central nervous system infections with nearly 70% choosing third-generation cephalosporin antibiotics alone or in combination with aminoglycosides or vancomycin. Patients diagnosed at stages II and III accounted for 82%. Some factors including: age, altered consciousness; signs of increased meningeal enhancement and ventricular dilation on MRI/CT and cellular components in cerebrospinal fluid, especially the number of lymphocytes > 50% were related to the time of diagnosis of tuberculous meningitis. Conclusion: Tuberculous meningitis in children at the National Children's Hospital is often diagnosed late with clinical stages II and III according to the British Medical Research Council. Age, altered consciousness; signs of increased meningeal enhancement and ventricular dilation on MRI/CT and cellular components in cerebrospinal fluid are factors related to the diagnosis of tuberculous meningitis.