Abstract

Introduction: Tuberculous Meningitis (TBM) is a manifestation of extra-pulmonary TB that causes inflammation of the meninges. TBM is also known as the deadliest form of TB disease. Malnutrition is one factor that increases the risk of severity and death of TB patients. In this study, we aimed to analyse the Total Lymphocyte Count (TLC) as a nutritional biomarker in TBM patients as a predictor of mortality by logistic regression technique to determine the effect of each variable on the outcome.

Methods: This study is a multivariate analytic study using secondary data. A bivariate correlation test analysed all the independent variables. Afterwards, the significant variable(s) were analysed independently by logistic regression to predict the best model for adverse patient outcomes. This study used 95% confidence intervals (CI), and variables with a significance value of p <0.05 were considered significant.

Results: A total of 209 patients' medical records were analysed in this study. The patients consisted of 105 males and 104 females ranging from 17-74 years old, with an average of 34 years old and median of 32 years old. Out of these, 53 patients (25.4%) died, and 156 patients (74.6%) were alive. In this present study, showed age (p = 0.002), hospitality duration (p <0.001), GCS (p = 0.032) and TLC (p <0.001) were independent predictors of death patient outcome.

Conclusion: In summary, our study showed that the TLC is a promising biomarker for TBM patients' outcomes and coinciding with patient characteristics, we can improve its predictive value. TLC is also known as a nutritional biomarker; thus, nutritional management is crucial to improve the outcome of TBM patients.

Keywords: Tuberculous meningitis; TBM; Total lymphocyte count; TLC; predictor; mortality