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- Title
HIV-A prognostic factor of tuberculous meningitis: A retrospective cohort study among adults in peninsular Malaysia.
- Authors
King-Fang Tan; Nyi Nyi Naing; Wan-Arfah, Nadiah; Tharakan, John; Rafia, Hanip; Hyder Ali, Irfhan Ali; Tarekh, Noor Aliza; Subramaniyan, Vetriselvan; Ling Shing Wong; Selvaraj, Siddharthan
- Abstract
Background: Tuberculous meningitis is a major public health issue, despite showing low incidence, tuberculous meningitis causes substantial mortality. For better clinical management, identification of prognostic factors is crucial to reduce health risk of Malaysian society. Therefore, the aim of this study was to determine the prognostic factors of adult tuberculous meningitis in peninsular Malaysia. Materials & methods: Initially, a retrospective cohort study and one-year of follow-up period was carried out. In addition, a total of 217 adult tuberculous meningitis patients treated or had follow-up in four tertiary hospitals in peninsular Malaysia were recruited. Cox proportional hazards regression was employed to perform multivariable analysis. Results: The overall survival probability of adult tuberculous meningitis was 36.8% with median survival time 244 days. Significant prognostic factors were Glasgow coma scale score (aHR=0.71, 95% CI=0.65, 0.76; p<0.001), HIV status (aHR=1.94, 95% confidence interval [CI]=1.19, 3.15; p=0.008), headache (aHR=0.48, 95% CI=0.31, 0.76; p=0.002) and meningeal enhancement (aHR=0.47, 95% CI=0.30, 0.74; p=0.001), nausea (aHR=2.21, 95% CI=1.33, 3.66; p=0.002), and vomit (aHR=0.58, 95% CI=0.36, 0.93; p=0.023). Conclusions: Evidently, the survival of among adults with tuberculous meningitis was low. Since HIV positive has a significant influence in mortality; early screening, diagnosis, and prompt treatment in this subgroup of patients play a key role in survival.
- Subjects
MALAYSIA; HIV infection complications; RISK assessment; TUBERCULOMA; MALAYSIANS; IMMIGRANTS; HYDROCEPHALUS; SURVIVAL rate; SAMPLE size (Statistics); COMPUTED tomography; RETROSPECTIVE studies; DESCRIPTIVE statistics; MAGNETIC resonance imaging; MULTIVARIATE analysis; LONGITUDINAL method; KAPLAN-Meier estimator; LOG-rank test; STATISTICS; COMPARATIVE studies; DATA analysis software; INDIANS (Asians); CONFIDENCE intervals; VOMITING; PROPORTIONAL hazards models; NAUSEA; DISEASE incidence
- Publication
Electronic Journal of General Medicine, 2024, Vol 21, Issue 2, p1
- ISSN
2516-3507
- Publication type
Article
- DOI
10.29333/ejgm/14402