Validation of Thwaites Index for diagnosing tuberculous meningitis in a Colombian population

Autor: Helena del Corral, Juan Carlos Arango, Sebastián Urrego, Carlos Santiago Uribe, Andrés Franco, María Eugenia Toro, Ángela Beatriz Pérez, Isabel Cristina Vásquez Vélez, Juan Sebastián Saavedra, Olga Elena Hernández, Jenny García
Rok vydání: 2016
Předmět:
Male
Human immunodeficiency virus (HIV)
HIV Infections
medicine.disease_cause
0302 clinical medicine
Child
Aged
80 and over

Likelihood Functions
Age Factors
Area under the curve
Middle Aged
Neurology
Area Under Curve
Tuberculosis
Meningeal

Infecciones por VIH - complicaciones
Meningeal Tuberculosis
Female
Bacterial meningitis
Tuberculosis Meníngea
Meningitis
Adult
medicine.medical_specialty
Tuberculosis
Adolescent
030231 tropical medicine
HIV Infections - complications
Colombia
Tuberculous meningitis
Meningitis
Bacterial

Diagnosis
Differential

Young Adult
03 medical and health sciences
Colombian population
Meningitis Bacterianas
Internal medicine
medicine
Humans
Aged
HIV Infections - cerebrospinal fluid
business.industry
Curva ROC
medicine.disease
Diagnóstico Diferencial
Cross-Sectional Studies
ROC Curve
Immunology
Neurology (clinical)
Infecciones por VIH - líquido cefalorraquídeo
business
Biomarkers
030217 neurology & neurosurgery
Zdroj: Repositorio UdeA
Universidad de Antioquia
instacron:Universidad de Antioquia
ISSN: 0022-510X
Popis: Objective.: To determine the diagnostic accuracy of Thwaites Index (TI) in a Colombian population to distinguish meningeal tuberculosis (MTB) from bacterial meningitis (BM) and from non-tuberculous meningitis. Exploratory analyses were conducted to assess the TI's validity for patients with human immunodeficiency virus (HIV) and children above six-years-old. Methods: The study included 527 patients, the TI was calculated and results compared with those of a reference standard established by expert neurologists. Sensitivity, specificity, area under the curve of receiver-operator characteristics (AUC-ROC) and likelihood ratios were calculated. Results: The AUC-ROC to distinguish MTB from non-tuberculous meningitis was 0.72 (95% CI: 0.67–0.77) for HIV negative adults. AUC-ROC was 0.62 (95% CI: 0.50–0.74) for HIV positive adults and 0.83 (95% CI: 0.68–0.97) for children. For distinguishing MTB from BM the AUC-ROC was 0.78 (95% CI: 0.73–0.83); furthermore, the AUC-ROC was 0.57 (95% CI: 0.31–0.83) for HIV positive adults and 0.86 (95% CI: 0.73–0.99) for children. Conclusion: The TI was sensitive but not specific when used to distinguish MTB from BM in HIV negative adults. In HIV positive adults the index had low diagnostic accuracy. Moreover, the TI showed discrimination capability for children over 6 years; however, research with larger samples is required in these. COL0102748 COL0007121 COL0126131
Databáze: OpenAIRE