Table 1.
Main Characteristics of Studies Reporting on the Effectiveness of Regimens to Treat Drug-Susceptible Tuberculous Meningitis in Children and Adolescents
| Study Reference | Study Design | Location | Years of Enrollment | Duration of Follow-up | Number of Patients | Treatment Regimen | Patients Receiving Steroids | Patient Characteristics | |||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Age | Female [n (%)] | HIV Status | Disease Stage (n per Stage) b |
||||||||
| Intervention Regimensa | |||||||||||
| Bang et al [13] | PC | Ho Chi Minh City, Vietnam | 2009–2011 | 8 months | 100 | 2HRZES/1HRZE/5HRE: H 5 mg/kg, R 10 mg/kg, Z 25 mg/kg, E 15 mg/kg, S 15 mg/kg | All | Median: 2.7 years (IQR 0.9–6.9 years) Range: 0.2–15 years |
44 (44.0) | 4/96 HIV-positive | 59 stage 1; 23 stage 2; 18 stage 3 |
| van Toorn et al [14] | PC | Western Cape, South Africa | 2006–2009 | ≥2 years after treatment completion | 135 | 6HRZEto: H 20 mg/kg, R 20 mg/kg, Z 40 mg/kg, Eto 20 mg/kg | All | Median: 2.9 years (IQR 1.5–7 years) Range: 0.2–14 years |
72 (53.3) | 6/135 HIV-positive | 16 stage 1; 68 stage 2; 51 stage 3 |
| 13 | 9HRZEto: H 20 mg/kg, R 20 mg/kg, Z 40 mg/kg, Eto 20 mg/kg | All | Median: 5.5 years (IQR 2.2–7.4 years) Range: 0.8–11 years |
3 (23.1) | All HIV-positive | 2 stage 1; 8 stage 2; 3 stage 3 |
|||||
| van Well et al [15] | RC | Western Cape, South Africa | 1985–2005 | 6 months | 554 | 6HRZEto: H 20 mg/kg, R 20 mg/kg, Z 40 mg/kg, Eto 20 mg/kg | 63% | Median: 2.3 years (IQR 1.3–4.2 years) Range: 0.2–15 years |
263 (47.5) | 8/213 HIV-positive | 14 stage 1; 318 stage 2; 222 stage 3 |
| Solomons et al (unpublished) | RC | Western Cape, South Africa | 2011–2014 | 6 months | 35 | 6HRZEto: H 20 mg/kg, R 20 mg/kg, Z 40 mg/kg, Eto 20 mg/kg | All | Median: 2.5 years (IQR 1.3–3.7 years) Range: 0.4–6.8 years |
16 (45.7) | 3/35 HIV-positive | 6 stage 1; 15 stage 2; 14 stage 3 |
| Comparator (WHO) Regimena | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Dhawan et al [16] | PC | India | 2010–2013 | 12 months after hospital discharge | 130 | 2HRZE/10HR: H 10 mg/kg, R 15–20 mg/kg, Z 35–40 mg/kg, E 20–25 mg/kg | All | NR | 50 (38.5) | All HIV-negative | 26 stage 1; 56 stage 2; 48 stage 3 |
| Gupta et al [17] | PC | Delhi, India | 2012–2014 | 12 months | 138 | 2HRZE/10HR: H 10–20 mg/kg, R 10–20 mg/kg, Z 30–35 mg/kg, E 15–20 mg/kg | NR | <18 years | NR | NRc | NR |
| Thee et al [12] | RC | Europe (multiple countries) | 2009–2016 | 12 months | 14 | 2HRZE/10HR: H 9.8 (5.8–12.1) mg/kg, R 11.8 (10.1–14.5) mg/kg, Z 28.8 (25.0–31.3) mg/kg, E 19.2 (17.0–20.1) mg/kgd | All | Median: 3.3 years Range: 1–16 years |
5 (35.7) | All HIV-negative | 2 stage 1; 11 stage 2; 1 stage 3 |
Abbreviations: E, ethambutol; Eto, ethionamide; H, isoniazid; HIV, human immunodeficiency virus; IQR, interquartile range; NR, not reported; PC, prospective cohort; RC, retrospective cohort; R, rifampin; SD, standard deviation; S, streptomycin; WHO, World Health Organization; Z, pyrazinamide.
Regimens of 6 to <12 months’ duration were classified as “intervention,” whereas 12-month regimens were classified as “comparator” (WHO).
Disease stage was defined in accordance with the British Medical Research Council scale in all studies; however, children younger than 5 years in Bang et al [13] were staged as per the Blantyre Coma Scale.
The study included both adults and children; 12 HIV-positive individuals were included in the entire cohort but their age distribution was not reported.
Reported doses are the median (25th and 75th percentile) doses given for each drug.