Outcome of tuberculous meningitis in children: the first comprehensive retrospective cohort study in Indonesia

BACKGROUND: Tuberculous meningitis (TBM) is the most severe form of extra-pulmonary tuberculosis. OBJECTIVE: To assess hearing, visual, motor function, neurological and mental development outcomes in paediatric TBM. METHODS: A retrospective cohort study was conducted among 139 children with TBM registered and treated at the Department of Child Health, Dr Hasan Sadikin Hospital, Bandung, Indonesia, from January 2007 to December 2010. Hearing and visual function, appearance of optic disc, motor function, and neurological and mental development were evaluated. RESULTS: Of a final 128 patients (10 died during hospitalisation, 1 was excluded), 34 (26.5%) died after hospital discharge, the addresses of 58 patients could not be found and 7 parents refused to participate. The remaining 29 patients (16 males, 13 females) were available for evaluation; the mean age was 44 months (range 7-162). Hearing loss and visual impairment were identified in respectively 11/28 and 10/25 patients. Most patients had motor disorders. Delayed neurological and mental development was observed in nearly three quarters of patients, 11 of whom had normal or borderline intelligence quotient. CONCLUSIONS: TBM causes high mortality and sequelae involving hearing and visual impairment, and neurological and mental development.