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Risk factors of neurodevelopmental delay in paediatric tuberculous meningitis

Thesis (MSc)--Stellenbosch University, 2022.

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Main Author: Saal, Caro-lee
Other Authors: Solomons, Regan
Format: Thesis
Language:en_ZA
Published: Stellenbosch : Stellenbosch University 2022
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access_status_str Open Access
author Saal, Caro-lee
author2 Solomons, Regan
author_browse Saal, Caro-lee
Solomons, Regan
author_facet Solomons, Regan
Saal, Caro-lee
author_sort Saal, Caro-lee
collection Thesis
dc_rights_str_mv Stellenbosch University
description Thesis (MSc)--Stellenbosch University, 2022.
format Thesis
id oai:scholar.sun.ac.za:10019.1/125049
institution Stellenbosch University (South Africa)
language en_ZA
last_indexed 2026-06-10T12:43:33.723Z
license_str Other — see source repository
provenance_str_mv Harvested via OAI-PMH from SUNScholar — Stellenbosch University Repository
publishDate 2022
publishDateRange 2022
publishDateSort 2022
publisher Stellenbosch : Stellenbosch University
publisherStr Stellenbosch : Stellenbosch University
record_format dspace
source_str SUNScholar — Stellenbosch University Repository
spelling oai:scholar.sun.ac.za:10019.1/125049 Risk factors of neurodevelopmental delay in paediatric tuberculous meningitis Saal, Caro-lee Solomons, Regan Esterhuizen, Tonya Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Global Health. Epidemiology and Biostatistics. Developmental disabilities Pediatric neuropsychiatry Neurodevelopmental delay Paediatric tuberculous meningitis UCTD Thesis (MSc)--Stellenbosch University, 2022. ENGLISH SUMMARY: Objective: Neurodevelopmental delay in children is one of the long-term complications of tuberculous meningitis (TBM) with significant social, financial and scholastic implications. The objective of the study was to assess the risk factors in children with case-defined TBM that could predict neurodevelopmental delay at the conclusion of anti-tuberculous treatment, after 6 months in HIV non-infected and 9 months in HIV co-infected. Methods: We conducted a retrospective cohort study of all the children diagnosed with TBM at a large academic hospital in Cape Town, South Africa, over a 30-year period between 1985 and 2015. We assessed the relationship between demographic, clinical, laboratory and neuro-imaging characteristics, with cognitive impairment at conclusion of anti-tuberculous treatment. Results: A total of 327 patients were included. The median age on admission was 28 months (interquartile range(IQR) 15-47) with females accounting for 159 (48.6%) and males 168 (51.4%).Of included participants 170 (52%) were HIV negative. Younger age at diagnosis was more likely to have lower IQ levels. Patients were more likely to have lower IQ levels if they had decreased level of consciousness (LOC) (OR=3.30, 95% CI: 1.80-6.05); brainstem dysfunction (OR=2.39, 95% CI: 1.42-4.02); motor function impairment (OR=1.96, 95% CI:1.14-3.39) and infarcts (OR=2.60, 95% CI: 1.53-4.42). Those with positive CSF culture results were less likely to have lower IQ levels (OR=0.38, 95% CI: 0.20-0.75) Conclusion: This study demonstrated that demographic (age on admission) and clinical characteristics (decreased level of consciousness, impaired motor function, brainstem dysfunction, cerebral infarcts, negative cerebrospinal fluid (CSF) culture) were independent risk factors for lower IQ levels at treatment conclusion, in children with clinically-defined TBM. AFRIKAANSE OPSOMMING: Geen opsomming beskikbaar. Masters 2022-02-16T12:36:07Z 2022-04-29T12:51:50Z 2022-08-16T03:00:12Z 2022-04 Thesis http://hdl.handle.net/10019.1/125049 en_ZA Stellenbosch University 16 pages application/pdf Stellenbosch : Stellenbosch University
spellingShingle Developmental disabilities
Pediatric neuropsychiatry
Neurodevelopmental delay
Paediatric tuberculous meningitis
UCTD
Saal, Caro-lee
Risk factors of neurodevelopmental delay in paediatric tuberculous meningitis
title Risk factors of neurodevelopmental delay in paediatric tuberculous meningitis
title_full Risk factors of neurodevelopmental delay in paediatric tuberculous meningitis
title_fullStr Risk factors of neurodevelopmental delay in paediatric tuberculous meningitis
title_full_unstemmed Risk factors of neurodevelopmental delay in paediatric tuberculous meningitis
title_short Risk factors of neurodevelopmental delay in paediatric tuberculous meningitis
title_sort risk factors of neurodevelopmental delay in paediatric tuberculous meningitis
topic Developmental disabilities
Pediatric neuropsychiatry
Neurodevelopmental delay
Paediatric tuberculous meningitis
UCTD
url http://hdl.handle.net/10019.1/125049
work_keys_str_mv AT saalcarolee riskfactorsofneurodevelopmentaldelayinpaediatrictuberculousmeningitis