TO DETERMINE THE ACCURACY OF HIGHLY SUSPECTED CLINICAL FEATURES FOR THE DIAGNOSIS OF TUBERCULOUS MENINGITIS
Introduction: Annually, 2 million people die as a result of this disease. Tuberculous meningitis (TBM) is the most
severe complication of tuberculosis and frequently occurs in childhood. According to WHO an estimated 13.7 million
population has active TB with 9.3 million new cases and 1.8 million deaths. Pakistan ranks sixth among the 22 countries
and has 44% TB burden in Eastern Mediterranean Region of WHO. There are 4% registered cases of TB in children
in Pakistan, 2.5% are at risk of getting infection. Only 5-10% of infected children will progress to primary progressive
disease while 80-90% will get latent TB. It accounts for 8-20%of all deaths in children. Meningitis is an important cause
of mortality and morbidity in children. It carries a risk of fatal outcome or severe neurological deficit, especially when
the diagnosis and treatment are delayed
Objective: To determine the accuracy of highly suspected clinical features for the diagnosis of tuberculous meningitis
confirmed by cerebrospinal fluid culture.
Methods: This was a cross sectional descriptive study of one year on 116 patients. All those children presenting with
highly suspected clinical features of duration > 4 weeks, Glasgow coma scale < 7, cranial nerve palsy and hemiplegia
suspected for having tuberculous meningitis who present through Out-patient department (OPD) or Emergency department
were admitted in Pediatric “A” Unit, of Postgraduate Medical Institute, Hayatabad Medical Complex, Peshawar.
Patients who fulfill the inclusion criteria were included in the study. Under strict aseptic conditions, lumber puncture
were done to collect CSF and were sent to the laboratory for the confirmation of Tuberculous Meningitis to check the
accuracy of clinical features.
Results: In this study, 116 patients with average clinical symptoms duration 30 days+ 8.66SD had observed, in which
Male to female ratio was 1.9:1. Average age was 37.83 months + 25.58SD. Accuracy of Clinical parameter to detect
tuberculosis meningitis in the study was 76(65.52%) while 40(34.48%) were found non-accurate results.
Conclusion: Tuberculous meningitis starts with nonspecific symptoms and is often only diagnosed when brain damage
has already occurred. Earlier diagnosis will improve outcome significantly and clinical parameters