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 |
| DOI: | 10.1016/j.jns.2016.09.007 |
| 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 |
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