Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 May 12;17(1):341.
doi: 10.1186/s12879-017-2447-0.

Total delay in treatment among tuberculous meningitis patients in China: a retrospective cohort study

Yu He  1   2 , Chao Han  3 , Kai-Feng Chang  4 , Mao-Shui Wang  5 , Tian-Ren Huang  6
Affiliations

Total delay in treatment among tuberculous meningitis patients in China: a retrospective cohort study

Yu He et al. BMC Infect Dis. .

Abstract

Background: Currently, there is limited data on the risk factors associated with treatment delay in tuberculous meningitis (TBM). This study aimed to assess the duration of delay in the treatment TBM and to investigate its determinants.

Methods: During the period from September 2009 to February 2016, a retrospective cohort study of consecutive TBM patients admitted to our hospital was conducted to determine the risk factors associated with treatment delay in TBM. Treatment delay duration was defined as the time interval from onset of symptoms (by patient recall) to initiation of treatment and was stratified into two categories: ≤ 20 days, >20 days (median delay day is 20 days). Data collected included demography, comorbidity, cerebrospinal fluid (CSF) examinations and others. Univariable and multivariable logistic regression analysis was used to evaluate the determinants of treatment delay.

Results: A total of 161 TBM patients were included in our study, all were confirmed by CSF mycobacterial culture. The median treatment delay for all patients included in the study was 20 days [interquartile range, 14-60 days]. Multivariate analysis revealed that age (≤21 years old, OR = 0.202, 95% CI: 0.079, 0.521), fever (OR = 0.414, 95% CI: 0.180, 0.952), and headache (OR = 0.204, 95% CI: 0.095, 0.442) had significantly lower risk for treatment delay, while multiple healthcare contact (>3 times) (OR = 3.938, 95% CI: 1.326, 11.691) as well as CSF chloride (>111 mmol/L) (OR = 2.479, 95% CI: 1.143, 5.377) had significantly higher risk of the delay.

Conclusions: Our findings indicate that multiple healthcare contact and high CSF chloride predict the risk of long delay, while young age, fever and headache are associated with short delay. Maintained focus on awareness of TBM in the population and in healthcare systems, and continuous implementation of diagnostic methods for TBM to detect the disease early, may reduce the mortality and morbidity.

Keywords: Factor; Treatment delay; Tuberculous meningitis.

PubMed Disclaimer

References

    1. World Health Organization Global tuberculosis report. http://www.who.int/tb/publications/global_report/en/. Accessed: 3 Oct 2015.
    1. Thwaites G, Fisher M, Hemingway C, Scott G, Solomon T, Innes J. British Infection Society guidelines for the diagnosis and treatment of tuberculosis of the central nervous system in adults and children. J Inf Secur. 2009;59(3):167–187. - PubMed
    1. Sheu JJ, Yuan RY, Yang CC. Predictors for outcome and treatment delay in patients with tuberculous meningitis. Am J Med Sci. 2009;338(2):134–139. doi: 10.1097/MAJ.0b013e3181a590f1. - DOI - PubMed
    1. Lu CH, Chang WN, Chang HW. The prognostic factors of adult tuberculous meningitis. Infection. 2001;29(6):299–304. doi: 10.1007/s15010-001-1100-3. - DOI - PubMed
    1. Karstaedt AS, Valtchanova S, Barriere R, Crewe-Brown HH. Tuberculous meningitis in south African urban adults. QJM. 1998;91(11):743–747. doi: 10.1093/qjmed/91.11.743. - DOI - PubMed

LinkOut - more resources