dexamethasone and long-term outcome of tuberculous meningitis in vietnamese adults and adolescents地塞米松和长期结果的结核性脑膜炎越南成人和青少年.pdfVIP

Dexamethasone and Long-Term Outcome of Tuberculous Meningitis in Vietnamese Adults and Adolescents ´ ¨ ¨ 1 2 3 2 4 M. Estee Torok *, Nguyen Duc Bang , Tran Thi Hong Chau , Nguyen Thi Bich Yen , Guy E. Thwaites , 2 2 3 3 5 Hoang Thi Quy , Nguyen Huy Dung , Tran Tinh Hien , Nguyen Tran Chinh , Hoang Thi Thanh Hoang , Marcel Wolbers5,6, Jeremy J. Farrar5,6 1 Department of Medicine, University of Cambridge, Cambridge, United Kingdom, 2 Pham Ngoc Thach Hospital, Ho Chi Minh City, Vietnam, 3 Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam, 4 Centre for Clinical Infection and Diagnostics Research, St. Thomas’s Hospital, Kings College London, London, United Kingdom, 5 Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam, 6 Centre for Tropical Medicine, University of Oxford, Oxford, United Kingdom Abstract Background: Dexamethasone has been shown to reduce mortality in patients with tuberculous meningitis but the long- term outcome of the disease is unknown. Methods: Vietnamese adults and adolescents with tuberculous meningitis recruited to a randomised, double-blind, placebo-controlled trial of adjunctive dexamethasone were followed-up at five years, to determine the effect of dexamethasone on long-term survival and neurological disability. Results: 545 patients were randomised to receive either dexamethasone (274 patients) or placebo (271 patients). 50 patients (9.2%) were lost to follow-up at five years. In all patients two-year survi