• Nicolette Nabukeera-Barungi, Jo Wilmshurst, Muloiwa Rudzani, and James Nuttall.
• Makerere University College of Health Sciences, Kampala, Uganda.
• Afr Health Sci. 2014 Mar 1; 14 (1): 143149143-9.

BackgroundDiagnosis of tuberculous meningitis (TBM) is complicated and outcome is poor especially in resource limited settings. Early diagnosis and prompt treatment are vital in effective treatment. We set out to describe experiences in the management and immediate outcome of TBM a tertiary-level children's hospital in a high HIV and tuberculosis co-infection setting.MethodsThis retrospective study included children who were diagnosed with TBM in the year 2009. A pre-coded questionnaire was used to extract data on presentation, diagnostics, treatment and outcome at the time of hospital discharge. Data was analyzed using STATA statistical package (StataCorp, Version 11).ResultsOf the 40 children diagnosed with TBM, 6 (15%) had definitive TBM, 17 (42.5%) had probable TBM and 17 (42.5%) had possible TBM. The cerebrospinal fluid (CSF) chemistry and cells were abnormal in 39/40 (98%). Mantoux test was reactive in 16/29 (55%) and 17/30 (57%) had Chest X-rays suggestive of tuberculosis. Only 3/21 (14%) had positive sputum tuberculosis culture and 89% (32/36) had neuro-imaging abnormalities. Outcome at discharge was; 8% died, 49% improved with neurological sequelae and 43% improved without sequelae. Having TBM stage 3 at admission was associated with mortality (p=0.001).ConclusionsMost children had early diagnosis of TBM and mortality was lower than in previous studies. We recommend a larger prospective study to further understand the outcome of TBM.

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