Long-term follow up of childhood tuberculous meningitis

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dc.contributor.authorSchoeman J.
dc.contributor.authorWait J.
dc.contributor.authorBurger Hons M.
dc.contributor.authorVan Zyl F.
dc.contributor.authorFertig G.
dc.contributor.authorVan Janse Rensburg A.
dc.contributor.authorSpringer P.
dc.contributor.authorDonald P.
dc.date.accessioned2011-05-15T16:16:14Z
dc.date.available2011-05-15T16:16:14Z
dc.date.issued2002
dc.description.abstractThe purpose of the present study was to determine the long-term outcome of 76 children (40 females and 36 males) diagnosed and treated with modern antituberculosis drugs. The median age of the children on admission was 29.5 months and on follow-up 9 years. Antituberculosis therapy consisted of daily isoniazid (20mg/kg), rifampicin (20mg/kg), ethionamide (20mg/kg), and pyrazinamide (40mg/kg) for 6 months. Twenty-three children received daily prednisone (2-4mg/kg) for the first month of treatment. Raised intracranial pressure was actively monitored and treated. Patients with non-communicating hydrocephalus received ventriculo-peritoneal shunts shortly after admission while communicating hydrocephalus was treated with oral acetazolamide (100mg/kg/day) and furosemide (1mg/kg/day) in 3-4 divided doses. Communicating hydrocephalus that did not respond to this regimen within the first month of treatment also underwent ventriculo-peritoneal shunting. Only 20% of children were functionally completely normal at follow-up. Main areas of functional deficit were cognitive impairment (80%), poor scholastic progress (43%), and emotional disturbance (40%). Twenty-five per cent of children had evidence of motor impairment, but all could walk and only 5 of 76 children (6% of total) were unable to run. One child was blind but no child had sensori-neural deafness. It was concluded that these disabilities in children from mainly deprived socioeconomic backgrounds have serious implications for their future social, academic, and career prospects. A high index of suspicion of TBM in high tuberculosis incidence communities will help prevent the morbidity documented in this study.
dc.description.versionArticle
dc.identifier.citationDevelopmental Medicine and Child Neurology
dc.identifier.citation44
dc.identifier.citation8
dc.identifier.issn00121622
dc.identifier.other10.1017/S0012162201002493
dc.identifier.urihttp://hdl.handle.net/10019.1/13690
dc.subjectacetazolamide
dc.subjectcorticosteroid
dc.subjectethionamide
dc.subjectfurosemide
dc.subjectisoniazid
dc.subjectprednisone
dc.subjectpyrazinamide
dc.subjectrifampicin
dc.subjecttuberculostatic agent
dc.subjectacademic achievement
dc.subjectadolescent
dc.subjectaffective neurosis
dc.subjectarticle
dc.subjectblindness
dc.subjectbrain ventricle peritoneum shunt
dc.subjectchild
dc.subjectchildhood disease
dc.subjectcognitive defect
dc.subjectcommunicating hydrocephalus
dc.subjectevaluation and follow up
dc.subjectfemale
dc.subjectfunctional assessment
dc.subjecthuman
dc.subjecthydrocephalus
dc.subjectinfant
dc.subjectintellectual impairment
dc.subjectintracranial hypertension
dc.subjectlong term care
dc.subjectmajor clinical study
dc.subjectmale
dc.subjectmedical documentation
dc.subjectmorbidity
dc.subjectmotor dysfunction
dc.subjectoutcomes research
dc.subjectpatient monitoring
dc.subjectpopulation risk
dc.subjectprevalence
dc.subjectpriority journal
dc.subjectquality of life
dc.subjectsocial life
dc.subjectsocial status
dc.subjecttreatment failure
dc.subjecttuberculosis control
dc.subjecttuberculous meningitis
dc.subjectAcetazolamide
dc.subjectAnti-Inflammatory Agents
dc.subjectAntitubercular Agents
dc.subjectBrain
dc.subjectChild
dc.subjectCognition Disorders
dc.subjectDiuretics
dc.subjectDrug Therapy, Combination
dc.subjectEthionamide
dc.subjectFemale
dc.subjectFollow-Up Studies
dc.subjectFurosemide
dc.subjectHumans
dc.subjectHydrocephalus
dc.subjectIsoniazid
dc.subjectMale
dc.subjectMycobacterium tuberculosis
dc.subjectPrednisolone
dc.subjectPyrazinamide
dc.subjectQuality of Life
dc.subjectRifampin
dc.subjectTuberculosis, Meningeal
dc.subjectVentriculoperitoneal Shunt
dc.subjectWechsler Scales
dc.titleLong-term follow up of childhood tuberculous meningitis
dc.typeArticle
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