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摩洛哥的神经脑膜结核严重程度:对流行病学趋势和治疗效果的批判性评估。

Severity of neuromeningeal tuberculosis in Morocco: a critical evaluation of epidemiological trends and treatment efficacy.

机构信息

Laboratory of Biology and Health, Faculty of Science, Ibn Tofail University, Kenitra, Morocco.

University Hassan First of Settat, Higher Institute of Health Sciences, Health Sciences and Technologies Laboratory, Settat, Morocco.

出版信息

Pan Afr Med J. 2024 Apr 29;47:216. doi: 10.11604/pamj.2024.47.216.42573. eCollection 2024.

DOI:10.11604/pamj.2024.47.216.42573
PMID:39247783
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11380608/
Abstract

INTRODUCTION

neuromeningeal tuberculosis (NMT) is a significant public health challenge in Morocco because of its acute severity and high mortality rates. This study aims to comprehensively evaluate the epidemiological, clinical, therapeutic, and disease progression characteristics of NMT in the Kenitra province.

METHODS

a retrospective analysis was conducted on the medical records of patients diagnosed with NMT at the Diagnostic Center of Tuberculosis and Respiratory Diseases in Kenitra from 2014 to 2017.

RESULTS

among the 33 identified NMT cases, predominantly males (57.6%) were affected, with an age range of 4-76 years and a median age of 25 years. Extrapulmonary manifestations were prevalent, constituting 78.8% (n=26) of all cases, with meningeal localization in 45.5% (n=15) of confirmed cases. Furthermore, 9.1% (n=3) of cases were associated with unconfirmed cerebral tuberculosis (TB), and 12% (n=4) exhibited miliary TB. Familial transmission and comorbidities were identified as significant factors in disease progression. More than half of the patients received standardized antibacillary treatment during hospitalization, which lasted between 9 and 12 months. Treatment outcomes were generally positive (73%), but a 12% case fatality rate and 15% loss to follow-up were observed.

CONCLUSION

this study highlights the complex clinical and public health challenges posed by NMT in Morocco. It emphasizes the need for improved health strategies that not only increase public awareness but also enhance the accessibility and quality of diagnostic services and treatment options.

摘要

简介

神经脑膜结核(NMT)在摩洛哥是一个严重的公共卫生挑战,因为它具有严重的急性和高死亡率。本研究旨在全面评估肯尼特拉省 NMT 的流行病学、临床、治疗和疾病进展特征。

方法

对 2014 年至 2017 年在肯尼特拉结核病和呼吸道疾病诊断中心诊断为 NMT 的患者的病历进行了回顾性分析。

结果

在确定的 33 例 NMT 病例中,主要为男性(57.6%),年龄范围为 4-76 岁,中位年龄为 25 岁。肺外表现常见,占所有病例的 78.8%(n=26),脑膜定位占确诊病例的 45.5%(n=15)。此外,9.1%(n=3)的病例与未确诊的脑结核(TB)有关,12%(n=4)表现为粟粒性 TB。家族传播和合并症被认为是疾病进展的重要因素。超过一半的患者在住院期间接受了标准化的抗结核治疗,治疗时间为 9-12 个月。治疗结果总体良好(73%),但有 12%的病死率和 15%的失访率。

结论

本研究强调了 NMT 在摩洛哥所带来的复杂临床和公共卫生挑战。它强调需要改善卫生策略,不仅要提高公众意识,还要加强诊断服务和治疗选择的可及性和质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/047a/11380608/0ed63c3b668e/PAMJ-47-216-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/047a/11380608/ebb5e66c3e3a/PAMJ-47-216-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/047a/11380608/c71d9621c64e/PAMJ-47-216-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/047a/11380608/0ed63c3b668e/PAMJ-47-216-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/047a/11380608/ebb5e66c3e3a/PAMJ-47-216-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/047a/11380608/c71d9621c64e/PAMJ-47-216-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/047a/11380608/0ed63c3b668e/PAMJ-47-216-g003.jpg

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刚果民主共和国金沙萨地区 HIV 感染者合并新型隐球菌性脑膜炎的流行病学、临床和生物学特征。
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