Incidence of tuberculous meningitis in France, 2000: a capture-recapture analysis.
OBJECTIVE
To estimate the incidence of culture-positive and culture-negative tuberculous meningitis (TBM) in France in 2000.


METHODS
Capture-recapture method using two unrelated sources of data: the tuberculosis (TB) mandatory notification system (MNTB), recording patients treated by anti-tuberculosis drugs, and a survey by the National Reference Centre (NRC) for mycobacterial drug resistance, recording culture-positive TBM.


RESULTS
Of 112 cases of TBM reported to the MNTB, 28 culture-positive and 34 culture-negative meningitis cases were validated (17 duplicates, 3 cases from outside France, 21 false notifications, and 9 lost records were excluded). The NRC recorded 31 culture-positive cases, including 21 known by the MNTB. When the capture-recapture method was applied to the reported culture-positive meningitis cases, the estimated number of meningitis cases was 41 and the incidence was 0.7 cases per million. Sensitivity was 75.6% for the NRC, 68.3% for the MNTB, and 92.7% for both systems together. When sensitivity of the MNTB for culture-positive cases was applied to culture-negative meningitis, the total estimated number of culture-negative meningitis cases was 50 and the incidence was 0.85 cases per million.


CONCLUSIONS
TBM is underestimated in France. Capture-recapture analysis using different sources to better estimate its incidence is of great interest.
Cailhol
J
J
Institut de Veille Sanitaire, Saint Maurice, France.
Che
D
D
Jarlier
V
V
Decludt
B
B
Robert
J
J
D000328:Adult; D018563:Disease Notification; D004352:Drug Resistance, Microbial; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D012680:Sensitivity and Specificity; D014390:Tuberculosis, Meningeal / Q000188:drug therapy / Q000453:epidemiology*