{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T19:56:25Z","timestamp":1774900585140,"version":"3.50.1"},"reference-count":22,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,8,6]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p>The aim of this study was to characterize and evaluate the risk factors for mortality in hospitalized patients with tuberculous meningitis (TBM). This was a retrospective study of hospitalized patients with TBM between 2016 and 2023 in Cear\u00e1 State, Brazil. Generalized linear regression was performed to identify factors predictive of in-hospital mortality. The British Medical Research Council Severity (BMRCS) grading system for TBM was evaluated upon patient admission. Of the 94 patients with TBM enrolled in the study, the median age was 39.6 years, 86.7% were men, 81.2% were positive for HIV upon admission, 33.0% had prior tuberculosis, and 4.3% had multidrug-resistant infections. In-hospital mortality was 31.9% for all patients with a final diagnosis of TBM. When multivariable analysis was applied, significant associations with increased in-hospital mortality were seen among patients with BMRCS grade III (odds ratio [OR] 1.42; 95% CI 0.49\u20134.08), low hemoglobin levels (OR 6.44; 95% CI 0.59\u201370.27), low hematocrit levels (OR 0.53; 95% CI 0.04\u20135.97), higher aspartate aminotransferase (AST) levels (OR 1.98; 95% CI 0.67\u20135.77), and fewer cerebrospinal fluid (CSF) lymphocytes (OR 1.38; 95% CI 0.50\u20133.80) and decreased in-hospital mortality in those with orally administered rifampin, isoniazid, pyrazinamide, and ethambutol (RHZE) (OR 0.28; 95% CI 0.10\u20130.79). Mortality was higher among patients with BMRCS grade III, low hemoglobin levels, low hematocrit levels, higher AST, and fewer CSF lymphocytes, and lower in those orally administered RHZE.<\/jats:p>","DOI":"10.4269\/ajtmh.24-0480","type":"journal-article","created":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T13:25:52Z","timestamp":1748352352000},"page":"412-420","source":"Crossref","is-referenced-by-count":1,"title":["The Clinical and Epidemiologic Factors Associated with Mortality in Tuberculous Meningitis in Cear\u00e1 State, Brazil"],"prefix":"10.4269","volume":"113","author":[{"given":"Lu\u00eds Arthur Brasil","family":"Gadelha Farias","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases of Hospital das Cl\u00ednicas, University of S\u00e3o Paulo, Laborat\u00f3rio de Investiga\u00e7\u00e3o M\u00e9dica \u2013 LIM 49, S\u00e3o Paulo, Brazil;"},{"name":"Hospital S\u00e3o Jos\u00e9 de Doen\u00e7as Infecciosas (HSJ), Fortaleza, Brazil;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aldenise de Olinda","family":"Castro","sequence":"additional","affiliation":[{"name":"Hospital S\u00e3o Jos\u00e9 de Doen\u00e7as Infecciosas (HSJ), Fortaleza, Brazil;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcos Maciel","family":"Sousa","sequence":"additional","affiliation":[{"name":"Hospital S\u00e3o Jos\u00e9 de Doen\u00e7as Infecciosas (HSJ), Fortaleza, Brazil;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marina Pinheiro Catunda","family":"Juc\u00e1","sequence":"additional","affiliation":[{"name":"Hospital S\u00e3o Jos\u00e9 de Doen\u00e7as Infecciosas (HSJ), Fortaleza, Brazil;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pedro Pinheiro de Negreiros","family":"Bessa","sequence":"additional","affiliation":[{"name":"Hospital S\u00e3o Jos\u00e9 de Doen\u00e7as Infecciosas (HSJ), Fortaleza, Brazil;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deborah Nayara Santos de","family":"Farias","sequence":"additional","affiliation":[{"name":"Christus Universitary Center (Unichristus), Fortaleza, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuliana de F\u00e1tima Lima","family":"Morais","sequence":"additional","affiliation":[{"name":"Christus Universitary Center (Unichristus), Fortaleza, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nathalia Camilla Maciel","family":"Jenkins","sequence":"additional","affiliation":[{"name":"Christus Universitary Center (Unichristus), Fortaleza, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberto da Justa","family":"Pires Neto","sequence":"additional","affiliation":[{"name":"Hospital S\u00e3o Jos\u00e9 de Doen\u00e7as Infecciosas (HSJ), Fortaleza, Brazil;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tania Maria Silva","family":"Coelho","sequence":"additional","affiliation":[{"name":"Hospital S\u00e3o Jos\u00e9 de Doen\u00e7as Infecciosas (HSJ), Fortaleza, Brazil;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melissa Soares","family":"Medeiros","sequence":"additional","affiliation":[{"name":"Hospital S\u00e3o Jos\u00e9 de Doen\u00e7as Infecciosas (HSJ), Fortaleza, Brazil;"},{"name":"Christus Universitary Center (Unichristus), Fortaleza, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Evelyne Santana","family":"Gir\u00e3o","sequence":"additional","affiliation":[{"name":"Hospital S\u00e3o Jos\u00e9 de Doen\u00e7as Infecciosas (HSJ), Fortaleza, Brazil;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maura Salaroli","family":"de Oliveira","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases of Hospital das Cl\u00ednicas, University of S\u00e3o Paulo, Laborat\u00f3rio de Investiga\u00e7\u00e3o M\u00e9dica \u2013 LIM 49, S\u00e3o Paulo, Brazil;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silvia Figueiredo","family":"Costa","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases of Hospital das Cl\u00ednicas, University of S\u00e3o Paulo, Laborat\u00f3rio de Investiga\u00e7\u00e3o M\u00e9dica \u2013 LIM 49, S\u00e3o Paulo, Brazil;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lauro Vieira","family":"Perdig\u00e3o Neto","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases of Hospital das Cl\u00ednicas, University of S\u00e3o Paulo, Laborat\u00f3rio de Investiga\u00e7\u00e3o M\u00e9dica \u2013 LIM 49, S\u00e3o Paulo, Brazil;"},{"name":"Hospital S\u00e3o Jos\u00e9 de Doen\u00e7as Infecciosas (HSJ), Fortaleza, Brazil;"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Lancet Infect Dis","first-page":"790","article-title":"Brazil tackles 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