title: Incidence of tuberculosis meningitis in a high HIV prevalence setting: time-series analysis from 2006 to 2011.
abstract: This study was undertaken at a tertiary hospital in Soweto, a peri-urban low-middle income setting. Mycobacterium tuberculosis meningitis (TBM) is a severe manifestation of extra-pulmonary tuberculosis.
  
  
  
  To describe the incidence, mortality and clinical features of TBM in human immunodeficiency virus (HIV) infected and non-infected children in South Africa from 2006 to 2011.
  
  
  
  A retrospective, cross-sectional descriptive study.
  
  
  
  Electronic databases and individual patient records of all children with a discharge diagnosis of TBM were reviewed to yield incidence rate ratios (IRR) in HIV-infected and non-infected children. Clinical, laboratory and radiological characteristics were compared between HIV-infected and non-infected children with TBM.
  
  
  
  Overall TBM incidence per 100 000 population in 2006 was 6.9 (95%CI 4.4-10.3) and 9.8 (95%CI 6.9-13.6) in 2009, but had subsequently declined to 3.1 (95%CI 1.6-5.5) by 2011. There was a significant reduction in the IRR of TBM among HIV-infected children (IRR 0.916, P = 0.036). The overall case fatality ratio was 6.7%. Clinical features, cerebrospinal fluid and computed tomography brain findings were similar in HIV-infected and non-infected children.
  
  
  
  TBM incidence decreased over the study period from 2006 to 2011, and was temporally associated with an increase in the uptake of antiretroviral treatment in HIV-infected individuals.
authors: Respiratory and Meningeal Pathogens Research Unit, Faculty of Health Sciences, Medical Research Council, University of the Witwatersrand, South Africa; Department of Science and Technology/National Research Foundation, Vaccine Preventable Diseases, Faculty of Health Sciences, University of the Witwatersrand, South Africa; Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, South Africa.
authors: S
authors: S
authors: Chaya
authors: Respiratory and Meningeal Pathogens Research Unit, Faculty of Health Sciences, Medical Research Council, University of the Witwatersrand, South Africa; Department of Science and Technology/National Research Foundation, Vaccine Preventable Diseases, Faculty of Health Sciences, University of the Witwatersrand, South Africa; Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, South Africa.
authors: Z
authors: Z
authors: Dangor
authors: Respiratory and Meningeal Pathogens Research Unit, Faculty of Health Sciences, Medical Research Council, University of the Witwatersrand, South Africa; Department of Science and Technology/National Research Foundation, Vaccine Preventable Diseases, Faculty of Health Sciences, University of the Witwatersrand, South Africa.
authors: F
authors: F
authors: Solomon
authors: Respiratory and Meningeal Pathogens Research Unit, Faculty of Health Sciences, Medical Research Council, University of the Witwatersrand, South Africa; Department of Science and Technology/National Research Foundation, Vaccine Preventable Diseases, Faculty of Health Sciences, University of the Witwatersrand, South Africa.
authors: S A
authors: SA
authors: Nzenze
authors: Respiratory and Meningeal Pathogens Research Unit, Faculty of Health Sciences, Medical Research Council, University of the Witwatersrand, South Africa; Department of Science and Technology/National Research Foundation, Vaccine Preventable Diseases, Faculty of Health Sciences, University of the Witwatersrand, South Africa.
authors: A
authors: A
authors: Izu
authors: Respiratory and Meningeal Pathogens Research Unit, Faculty of Health Sciences, Medical Research Council, University of the Witwatersrand, South Africa; Department of Science and Technology/National Research Foundation, Vaccine Preventable Diseases, Faculty of Health Sciences, University of the Witwatersrand, South Africa, National Institute for Communicable Diseases, Division of National Health Laboratory Service, Centre for Vaccines and Immunology, Sandringham, South Africa.
authors: S A
authors: SA
authors: Madhi
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D015995:Prevalence; D012189:Retrospective Studies; D013019:South Africa / Q000453:epidemiology; D014390:Tuberculosis, Meningeal / Q000175:diagnosis* / Q000453:epidemiology*