Neurocognitive outcomes of tuberculous meningitis in a primarily HIV-positive Ugandan cohort
Year: 2022
Type: article
Study design: Observational Study
Abstract: Background: The toll of tuberculous meningitis (TBM) in both mortality and disability is considerable, but advancements in rehabilitation have the potential to improve the functional abilities and the quality of survivors’ lives. However, the typical phenotype of neurocognitive impairment in TBM survivors remains unstudied in HIV-predominant populations in sub-Saharan Africa. Methods: We tested 36 survivors of TBM in Uganda with a comprehensive battery of neurocognitive assessments at 8 and 24 weeks after diagnosis, and compared results to a representative cohort of HIV-uninfected Ugandans. Results: While participants had a broad range of impairments at eight weeks, there was marked improvement by 24 weeks, when a phenotype of impairment including deficits in motor functioning, verbal learning and memory, processing speed, and executive function emerged. These deficits were present despite good clinician-rated functional status. The majority (23/27, 85%) had evidence of moderate to severe depression at week 8, and at week 24 (18/24, 75%). Conclusion: These findings highlight the need for more comprehensive neurocognitive assessment in the survivors of TBM, and further investment in and study of rehabilitation, including management of depression, to improve long-term outcomes in this population.
Source: Wellcome Open Research
Institutions: Brigham and Women's Hospital, University of California San Francisco Medical Center, Infectious Diseases Institute, Makerere University, University of Minnesota, University of Minnesota System, London School of Hygiene & Tropical Medicine, MRC/UVRI & LSHTM Uganda Research Unit, Uganda Virus Research Institute, Brighton and Sussex Medical School, University of Sussex
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $1,128
Funders: Wellcome Trust, Government of the United Kingdom, National Institute for Health and Care Research, New Partnership for Africa's Development, African Academy of Sciences, Medical Research Council, Alliance for Accelerating Excellence in Science in Africa, National Institute of Mental Health, National Institute of Allergy and Infectious Diseases, Fogarty International Center, National Institute of Neurological Disorders and Stroke
Awards: Makerere University UVRI Centre of Excellence for Infection & Immunity Research and Training (MUII-plus), Neuroinflammation and Modulating Factors in Depression and HIV, G4044476780, G580129446, G7279930290, G7853697249, Improving diagnosis and treatment of TB meningitis, G857320834, Improving diagnosis and treatment of TB meningitis, Improving Diagnostics and Neurocognitive Outcomes in HIV/AIDS-related Meningitis
OpenAlex ID: W4214944751