{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T17:52:07Z","timestamp":1793641927205,"version":"4.5.1"},"reference-count":37,"publisher":"Oxford University Press (OUP)","issue":"12","funder":[{"name":"Gatorade Trust"},{"name":"Department of Medicine of the University of Florida"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Despite advancements in tuberculosis (TB) control and treatment in the United States (US), patients with central nervous system TB (CNS-TB) continue to experience significantly higher mortality rates than those without CNS-TB. This raises concerns regarding clinical management and the need for a deeper understanding of the risk factors contributing to these deaths. This study aimed to determine the predictors of mortality in patients with CNS-TB.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We conducted a retrospective 1:2 propensity score\u2013matched case-control study. Cases were TB patients diagnosed with TB of the meninges, brain, spinal cord, or peripheral nerves, as documented in the Florida Department of Health (FDOH) TB registry, between 2009 and 2021. Controls were TB patients without CNS-TB, also reported in the FDOH TB registry during the same timeframe. We employed conditional logistic regression models to investigate the factors contributing to mortality in cases compared with controls.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We analyzed data from 116 cases and 232 matched controls. Patients with CNS-TB had a 5.69-fold higher risk of death than those without CNS-TB (adjusted odds ratio [aOR], 5.69 [95% confidence interval {CI}, 2.91\u201311.6]). Increased risk of death was associated with human immunodeficiency virus (HIV) coinfection (aOR, 1.93 [95% CI, .82\u20134.37]) and diabetes (aOR, 3.13 [95% CI, 1.28\u20137.47]). Miliary TB and non-HIV immunosuppression were significantly associated with being a case, while cavitary TB was less likely to be associated with being a case.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Clinical management should prioritize screening and close monitoring of patients with HIV coinfection and diabetes to improve patient outcomes.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ofid\/ofad559","type":"journal-article","created":{"date-parts":[[2023,11,10]],"date-time":"2023-11-10T06:56:00Z","timestamp":1699599360000},"source":"Crossref","is-referenced-by-count":9,"title":["Central Nervous System Tuberculosis: Risk Factors for Mortality in a Propensity Score\u2013Matched Case-Control Study"],"prefix":"10.1093","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2409-2061","authenticated-orcid":false,"given":"Michael","family":"Asare-Baah","sequence":"first","affiliation":[{"name":"Department of Epidemiology, College of Public Health and Health Professions, College of Medicine, University of Florida , Gainesville, Florida , USA"},{"name":"Emerging Pathogens Institute, University of Florida , Gainesville, Florida , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lori","family":"Johnston","sequence":"additional","affiliation":[{"name":"Bureau of Tuberculosis Control, Florida Department of Health , Tallahassee, Florida , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatiana","family":"Ramirez-Hiller","sequence":"additional","affiliation":[{"name":"Pediatric Research Hub, Department of Pediatrics, College of Medicine, University of Florida , Gainesville, Florida , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie Nancy","family":"S\u00e9raphin","sequence":"additional","affiliation":[{"name":"Emerging Pathogens Institute, University of Florida , Gainesville, Florida , USA"},{"name":"Division of Infectious Diseases and Global Medicine, College of Medicine, University of Florida , Gainesville, Florida , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Lauzardo","sequence":"additional","affiliation":[{"name":"Emerging Pathogens Institute, University of Florida , Gainesville, Florida , USA"},{"name":"Division of Infectious Diseases and Global Medicine, College of Medicine, University of Florida , Gainesville, Florida , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,11,8]]},"reference":[{"key":"2023122900454041100_ofad559-B1","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1128\/CMR.00042-07","article-title":"Central nervous system tuberculosis: pathogenesis and clinical aspects","volume":"21","author":"Rock","year":"2008","journal-title":"Clin Microbiol Rev"},{"key":"2023122900454041100_ofad559-B2","doi-asserted-by":"crossref","first-page":"23","DOI":"10.18683\/germs.2021.1237","article-title":"Comparative analysis between tuberculous meningitis and other forms of extrapulmonary tuberculosis","volume":"11","author":"Hammami","year":"2021","journal-title":"Germs"},{"key":"2023122900454041100_ofad559-B3","doi-asserted-by":"crossref","first-page":"1101","DOI":"10.2217\/fmb.12.86","article-title":"Tuberculous meningitis in adults: a review of a decade of developments focusing on prognostic factors for 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