Tuberculous meningitis in children: a forgotten public health emergency
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
Tuberculous meningitis (TBM) remains a major cause of morbidity and mortality in children with tuberculosis (TB), yet there are
currently no estimates of the global burden of paediatric TBM. Due to frequent non-specific clinical presentation and limited and
inadequate diagnostic tests, children with TBM are often diagnosed late or die undiagnosed. Even when diagnosed and treated, 20%
of children with TBM die. Of survivors, the majority have substantial neurological disability with significant negative impact on
children and their families. Surveillance data on this devastating form of TB can help to quantify the contribution of TBM to the
overall burden, morbidity and mortality of TB in children and the epidemiology of TB more broadly.
Paediatric TBM usually occurs shortly after primary infection with Mycobacterium tuberculosis and reflects ongoing TB
transmission to children. In this article we explain the public health importance of paediatric TBM, discuss the epidemiology within
the context of overall TB control and health system functioning and the limitations of current surveillance strategies. We provide a
clear rationale for the benefit of improved surveillance of paediatric TBM using a TB care cascade framework to support
monitoring and evaluation of paediatric TB, and TB control more broadly. Considering the public health implications of a diagnosis
of TBM in children, we provide recommendations to strengthen paediatric TBM surveillance and outline how improved surveillance
can help us identify opportunities for prevention, earlier diagnosis and improved care to minimize the impact of TBM on children
globally.
currently no estimates of the global burden of paediatric TBM. Due to frequent non-specific clinical presentation and limited and
inadequate diagnostic tests, children with TBM are often diagnosed late or die undiagnosed. Even when diagnosed and treated, 20%
of children with TBM die. Of survivors, the majority have substantial neurological disability with significant negative impact on
children and their families. Surveillance data on this devastating form of TB can help to quantify the contribution of TBM to the
overall burden, morbidity and mortality of TB in children and the epidemiology of TB more broadly.
Paediatric TBM usually occurs shortly after primary infection with Mycobacterium tuberculosis and reflects ongoing TB
transmission to children. In this article we explain the public health importance of paediatric TBM, discuss the epidemiology within
the context of overall TB control and health system functioning and the limitations of current surveillance strategies. We provide a
clear rationale for the benefit of improved surveillance of paediatric TBM using a TB care cascade framework to support
monitoring and evaluation of paediatric TB, and TB control more broadly. Considering the public health implications of a diagnosis
of TBM in children, we provide recommendations to strengthen paediatric TBM surveillance and outline how improved surveillance
can help us identify opportunities for prevention, earlier diagnosis and improved care to minimize the impact of TBM on children
globally.
Date Issued
2022-03-17
Date Acceptance
2022-02-20
Citation
Frontiers in Neurology, 2022, 13, pp.1-9
ISSN
1664-2295
Publisher
Frontiers Media
Start Page
1
End Page
9
Journal / Book Title
Frontiers in Neurology
Volume
13
Copyright Statement
© 2022 du Preez, Jenkins, Donald, Solomons, Graham, Schaaf, Starke, Hesseling and Seddon. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
License URL
Identifier
https://www.frontiersin.org/articles/10.3389/fneur.2022.751133/full
Subjects
children
pediatric
surveillance
tuberculosis
tuberculous meningitis
1103 Clinical Sciences
1109 Neurosciences
1701 Psychology
Publication Status
Published
Article Number
751133
Date Publish Online
2022-03-17