Baseline characteristics and drug doses of Indonesian children with TBM
| Characteristics | Value |
| Total cases, n | 20 |
| Female sex (n (%)) | 11 (55.0) |
| Age, years (median (IQR)) | 11.4 (4.4–14.7) |
| Age (n (%)) | |
| <5 years | 5 (25.0) |
| 5–9 years | 4 (20.0) |
| 10–14 years | 6 (30.0) |
| 15–18 years | 5 (25.0) |
| BCG-vaccinated (n (%)) | 11 (55.0) |
| Nutritional status* | |
| Weight for age Z-score (median (IQR))† | −2.08 (−3.06 to −1.32) |
| Height for age Z-score (median (IQR)) | −2.10 (−2.44 to −1.21) |
| BMI for age Z-score (median (IQR)) | −2.22 (−2.98 to −1.02) |
| Head circumference, cm (median (IQR)) | 50.0 (45.6–52.2) |
| Upper arm circumference, cm (median (IQR)) | 16.2 (12.6–20.6) |
| Abdominal circumference, cm (median (IQR)) | 52.5 (46.7–58.2) |
| Malnourished, n (%) | 14 (70.0) |
| Temperature, °C (median (IQR)) | 37.1 (37.0–37.8) |
| Chief complaint (n (%)) | |
| Severe headache | 3 (15.0) |
| Seizures | 4 (20.0) |
| Decreased consciousness | 9 (45.0) |
| Others | 4 (20.0) |
| Diagnostic score (median (IQR))‡ | 10.5 (10.0–12.0) |
| GCS (median (IQR)) | 13.0 (11.0–15.0) |
| Chest radiography, suggestive TB (n (%)) | 8 (40.0) |
| TBM category | |
| Possible TBM | 2 (10.0) |
| Probable TBM | 18 (90.0) |
| TBM grade (n (%))§ | |
| Grade 1 | 4 (20.0) |
| Grade 2 | 12 (60.0) |
| Grade 3 | 4 (20.0) |
| CSF baselines (median (IQR)) | |
| Leucocytes, cells/µL | 88.0 (41.0–134.2) |
| PMN, cells/µL | 20.5 (5.0–43.7) |
| MN, cells/µL | 79.5 (56.2–95.0) |
| Protein, mg/dL | 176.9 (80.7–287.5) |
| CSF/blood glucose ratio (median (IQR)) | 0.17 (0.10–0.44) |
| CSF smear microscopy (n (%)) | |
| Negative | 15 (75.0) |
| Not tested | 5 (25.0) |
| Cerebral imaging, done (n (%))¶ | 12 (60.0) |
| Abnormal | 11 (55.0) |
| Hydrocephalus | 7 (35.0) |
| Basal meningeal enhancement | 4 (20.0) |
| Brain oedema | 4 (20.0) |
| Midline shift | 2 (10.0) |
| Tuberculoma | 1 (5.0) |
| Infarct | 1 (5.0) |
| Intracerebral haemorrhage | 1 (5.0) |
| Normal | 1 (5.0) |
| GeneXpert MTB/RIF testing (extraneural), done (n (%))** | 4 (20.0) |
| M.tb detected, susceptible to rifampicin | 3 (15.0) |
| M.tb not detected | 1 (5.0) |
| Blood test values (median (IQR)) | |
| Creatinine, mg/dL | 0.5 (0.3–0.6) |
| Albumin, g/dL | 3.2 (2.4–3.5) |
| Protein, g/dL | 7.6 (6.9–8.4) |
| Random blood glucose, mg/dL | 107.0 (102.0–119.0) |
| AST, IU/L | 22.0 (16.0–33.0) |
| ALT, IU/L | 16.0 (13.0–30.0) |
| Drug administration through NGT on PK1 (n (%)) | 14 (70.0) |
| Drug administration through NGT on PK2 (n (%)) | 4/12 (20.0) |
| Daily drug doses on PK1 (median (IQR)) | |
| Isoniazid (mg/kg) | 8.9 (7.7–11.0) |
| Rifampicin (mg/kg) | 13.4 (11.6–16.4) |
| Pyrazinamide (mg/kg) | 26.7 (23.1–32.9) |
| Ethambutol (mg/kg) | 20.5 (19.1–21.6) |
*Anthropometric data were transformed into weight-for-age, height-for-age and BMI-for-age Z-scores based on the WHO standard reference populations using the R package ‘zscorer’ V.0.3.1. Malnutrition was defined as children aged <5 years with weight-for-age or height-for-age Z-scores <−2 SD and children aged ≥5 years with height-for-age or BMI-for-age Z-scores <−2 SD.
†Weigh for age Z-score can only be calculated for nine children.
‡Diagnostic score was assessed using a uniform case definition criteria for TBM by Marais et al.15
§Severity of TBM was classified according to the modified British Medical Research Council grading system as 1 (GCS of 15 with no focal neurological signs), 2 (GCS of 11–14 or 15 with focal neurological signs) or 3 (GCS<10).44
¶During hospitalisation, head computed tomographic scan was performed in 11 (55%) of 20 patients and head magnetic resonance imaging was performed in 1 (5%) of 20 patients.
**Three patients were susceptible to rifampicin using GeneXpert testing from gastric lavage sample, and one patient had no M. tb detected in sputum sample.
ALT, alanine aminotransferase; AST, aspartate aminotransferase; BMI, body mass index; CSF, cerebrospinal fluid; GCS, Glasgow Coma Scale; MN, mononuclear cells; NGT, nasogastric tube; PK1 and PK2, first and second pharmacokinetic sampling assessments; PMN, polymorphonuclear cells; TBM, tuberculous meningitis.