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Annals of Indian Academy of Neurology
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ORIGINAL ARTICLE
Year : 2014  |  Volume : 17  |  Issue : 3  |  Page : 281-286

Major outcomes of patients with tuberculous meningitis on directly observed thrice a week regime


1 Department of Neurology, Government Medical College, Thiruvananthapuram, Kerala, India
2 Department of Community Medicine, Government Medical College, Thiruvananthapuram, Kerala, India
3 Department of Medicine, Government Medical College, Thiruvananthapuram, Kerala, India

Correspondence Address:
Thomas Iype
Department of Neurology, Government Medical College, Thiruvananthapuram - 695 011, Kerala
India
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Source of Support: State Board of Medical Research, Government of Kerala, Conflict of Interest: None


DOI: 10.4103/0972-2327.138496

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Background: Revised National Tuberculosis Control Programme (RNTCP) of Government of India provides intermittent thrice-a-week directly observed treatment short course (RNTCP regimen). Objective: Assessments of all-cause mortality and nine-month morbidity outcomes of patients with tuberculous meningitis (TBM) on RNTCP regimen. Materials and Methods: We prospectively followed up patients registered with RNTCP center, with a diagnosis of TBM from January 1 st , 2010 to December 31 st , 2011. Morbidity was assessed using modified Rankin Scale (mRS). Results: We had 43 patients with median duration for follow-up of 396 days and that of survivors of 425 days. Two patients defaulted. Fourteen patients (32.5%) had mRS score of 4 to 6 and 29 had mRS of 0 to 3 after 9-month treatment. Severe disability was not related to any factor on logistic regression. Severe disability was seen in one patient (6.66%) among the 15 patients with stage 1, nine (37.5%) out of 24 patients with stage 2 and three (75%) out of 4 patients with stage 3 disease. Eight patients died (18.6%) of whom 4 died during the intensive phase and 4 during the continuation phase of RNTCP regimen. Mortality was independently related to treatment failure with adjusted Hazard ratio of 8.29 (CI: 1.38-49.78) (P = 0.02). One patient (6.66%) died out of the 15 patients with stage 1 disease, 5 (20.8%) out of 24 patients with stage 2 disease and 2 (50%) out of the 4 with stage 3 disease. Discussion and Conclusion: RNTCP regimen was associated with good compliance, comparable mortality and morbidity.


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