Research Article

Neuromeningeal Tuberculosis at The Brazzaville University Hospital: Prevalence and Associated Factors

Authors: Ossibi Ibara BR, Ekat M, Atipo-Tsiba PW, Adoua Doukaga T, Kosso Ilecko Omboumbou A, Angonga Pabota E, Ossou Nguiet PM, Ellenga-Mbolla BF

DOI: 10.33425/2639-9458.1078

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Abstract

Goal: To determine the prevalence of neuromeningeal tuberculosis in Brazzaville University Hospital and to investigate the associated factors.

Patients and Method: Data was collected from cases of neuromeningeal tuberculosis admitted to the Infectious Diseases Service of the University Hospital of Brazzaville during the period from March 1, 2014 to March 31, 2019.

Results: Fifty-six patients included (1.38% of admissions) with an average age of 42 ± 11.7 years (range, 23 to 70 years), mostly female (n = 38, 67.9%) with a sex- ratio of 0.5; unemployed (n = 20, 35.71%), urban residents (n = 51, 91.1%) and single (n = 29, 51.8%). 17 patients (30.4%) had a history of tuberculosis; 83.9% of the patients were HIV positive. The main reasons for consultation were Fever (n = 56, 100%), behavioral disorders (n = 25, 44.6%), and consciousness disorders (n = 22, 39.3%). The average consultation time was 15 days (range: 1 and 26 days). AEG (n = 51, 91.1%), the main signs of examination were impaired consciousness (n = 96, 4%), and stiff neck (n = 17, 30.35%). Five patients (8.9%) were found with ophthalmological abnormalities including tubers of Bouchut. The appearance of the LCS was clear (73.2%), disorder (1.8%), hyperproteinorrheia (68.9%), hypoglycorachia (91.1%). A localization associated with TNM was found in 34 cases (60.7%) dominated by pulmonary involvement in 21 cases (61.8%). The treatment duration was 5 days on average (range 0 to 18 days). Overall lethality was 53.6%, mainly due to severe anemia (n = 10, 33.3%).

Age (SHR = 3.5, CI: 1.14-9.29, P = 0.03), Treatment (SHR = 0.67, CI: 0.57-0.79, P = 0, 00) and route of administration (HR: 3.71, CI: 1.62-8.48, P = 0.002) influenced the death of patients with a probability of survival in untreated patients between 6-7 days = 0.28, IC; 0.01-1.61 and in patients treated between 6-7 days = 0.93; IC: 0.82-0.97.

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