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TB meningitis ‘fully treatable if detected early’

File photo: A toddler in the arms of her mother after TB meningitis left her partially paralysed.

File photo: A toddler in the arms of her mother after TB meningitis left her partially paralysed.

Published Jun 14, 2016

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Cape Town - Children suffering from TB meningitis (TBM) are often admitted to hospital too late, leading to strokes and brain damage and sometimes even death.

Research conducted by Stellenbosch University has shown that only 15 percent of children admitted to Tygerberg Children’s Hospital with TBM are in the early stage of the disease.

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The Western Cape has among the highest incidence of TBM in the world, with 50 children being admitted to the Tygerberg Children’s Hospital annually.

By the time most children with TBM are admitted, they are already showing depressed levels of consciousness or have had strokes, or fallen into a coma.

According to paediatric neurologist at the Tygerberg Children’s Hospital, Dr Regan Solomons, children are often admitted too late to change their condition.

TBM can be devastating for children, leading to death or permanent disability, yet the disease can be treated, and death prevented, if caught in time.

“This is tragic, considering that TBM, if detected early, is fully treatable with a completely normal outcome.”

The hospital has the highest survival rate globally, at over 96 percent. However, while they are likely to survive, their chances of leading a normal, healthy life are often compromised. Children aged between two and four are particularly at risk.

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“Once TB has spread to the brain, it can result in permanent disability, such as cerebral palsy, epilepsy, severe behaviour problems and blindness,” Solomons said.

TB is spread from adults to children in one of its most common forms, pulmonary TB.

“It only takes a few droplets of a sneeze or cough for TB to spread from an adult to a child. TB will first go to the lungs and then spread to the brain, causing TBM.”

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Solomons’s research has shown that chest X-rays do not necessarily detect TB.

“If the chest X-ray is normal, be vigilant, because it doesn’t necessarily mean there’s no TB.”

His research also showed that measuring blood glucose at the same time could improve a diagnosis.

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He said although symptoms are not easy to detect, parents, caregivers, doctors and nurses need to be aware of the warning signs.

“If a child has a persistent cough, night sweats, vomiting, poor appetite and if they’ve lost weight, TBM could be an option.

“It’s also very important to ask if a child has come into contact with an adult with TB. TBM symptoms tend to be longer than five days.”

He said it was sometimes misdiagnosed as gastro, and once a child was diagnosed, they needed to be put on a six-month treatment of four drugs.

Professor Mariana Kruger, of the Paediatrics and Child Health department at Stellenbosch University, supports Solomons in the important work he does.

“What is remarkable about PhD graduates such as Dr Solomons is that they are full-time clinicians, taking care of children on a daily basis and successfully combining their research with active service delivery.”

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