The global burden of tuberculous meningitis in adults : a modelling study

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dc.contributor.authorDodd, Peter J.en_ZA
dc.contributor.authorOsman, Muhammaden_ZA
dc.contributor.authorCresswell, Fiona V.en_ZA
dc.contributor.authorStadelman, Anna M.en_ZA
dc.contributor.authorLan, Nguyen Huuen_ZA
dc.contributor.authorThuong, Nguyen Thuy Thuongen_ZA
dc.contributor.authorMuzyamba, Morrisen_ZA
dc.contributor.authorGlaser, Lisaen_ZA
dc.contributor.authorDlamini, Sicelo S.en_ZA
dc.contributor.authorSeddon, James A.en_ZA
dc.date.accessioned2022-01-03T12:08:25Z
dc.date.available2022-01-03T12:08:25Z
dc.date.issued2021-12
dc.descriptionCITATION: Dodd, P. J. et al. 2021. The global burden of tuberculous meningitis in adults : a modelling study. PLoS Global Public Health, 1(12):e0000069, doi:10.1371/journal.pgph.0000069.
dc.descriptionThe original publication is available at https://journals.plos.org
dc.description.abstractTuberculous meningitis (TBM) is the most lethal form of tuberculosis. The incidence and mortality of TBM is unknown due to diagnostic challenges and limited disaggregated reporting of treated TBM by existing surveillance systems. We aimed to estimate the incidence and mortality of TBM in adults (15+ years) globally. Using national surveillance data from Brazil, South Africa, the United Kingdom, the United States of America, and Vietnam, we estimated the fraction of reported tuberculosis that is TBM, and the case fatality ratios for treated TBM in each of these countries. We adjusted these estimates according to findings from a systematic review and meta-analysis and applied them to World Health Organization tuberculosis notifications and estimates to model the global TBM incidence and mortality. Assuming the case detection ratio (CDR) for TBM was the same as all TB, we estimated that in 2019, 164,000 (95% UI; 129,000–199,000) adults developed TBM globally; 23% were among people living with HIV. Almost 60% of incident TBM occurred in males and 20% were in adults 25–34 years old. 70% of global TBM incidence occurred in Southeast Asia and Africa. We estimated that 78,200 (95% UI; 52,300–104,000) adults died of TBM in 2019, representing 48% of incident TBM. TBM case fatality in those treated was on average 27%. Sensitivity analysis assuming improved detection of TBM compared to other forms of TB (CDR odds ratio of 2) reduced estimated global mortality to 54,900 (95% UI; 32,200–77,700); assuming instead worse detection for TBM (CDR odds ratio of 0.5) increased estimated mortality to 125,000 (95% UI; 88,800–161,000). Our results highlight the need for improved routine TBM monitoring, especially in high burden countries. Reducing TBM incidence and mortality will be necessary to achieve the End TB Strategy targets.en_ZA
dc.description.versionPublisher's version
dc.format.extent15 pages
dc.identifier.citationDodd, P. J. et al. 2021. The global burden of tuberculous meningitis in adults : a modelling study. PLoS Global Public Health, 1(12):e0000069, doi:10.1371/journal.pgph.0000069.
dc.identifier.issn2767-3375 (online)
dc.identifier.otherdoi:10.1371/journal.pgph.0000069
dc.identifier.urihttp://hdl.handle.net/10019.1/124033
dc.language.isoen_ZAen_ZA
dc.publisherPublic Library of Science
dc.rights.holderAuthors retain copyright
dc.subjectMeninges -- Tuberculosisen_ZA
dc.subjectMeningitis -- Diagnosisen_ZA
dc.titleThe global burden of tuberculous meningitis in adults : a modelling studyen_ZA
dc.typeArticleen_ZA
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