Prevalence and characteristics of tuberculous meningitis in Malaysia (2015-2020)

Tuberculosis (TB) is one of the top 10 causes of death and the leading cause of morbidity from a single infectious agent. Tuberculous meningitis (TBM) is a subtype of tuberculosis which constitutes about 5% of all extrapulmonary tuberculosis and about 1-2% of active tuberculosis. This study was conducted to analyse the annual incidence of TBM in Malaysia from 2015-2020. Through this study we were also able to study the demographic characteristics and clinical profiles of TBM patients. It was a cross sectional study using data collected from Malaysia national case-based TB registry (MyTB) between year 2015 and 2020. Descriptive analysis was used and univariate analysis was performed using binary logistic regression. All the statistical analyses with p-value less than 0.05 is considered significant with the 95% confidence interval. There were total of 2072 TBM cases from year 2015 until 2020, which comprised of 1.38% of total TB cases within 6 years. Most of the patients were Malaysian (1682 cases (81.2%)) while only 390 (18.8%) cases were reported among foreigners. Most cases were detected among the age group of 35-44 with average of 77.8 (22.5%) cases per year, followed by age group 35-44 with average of 66.8 (19.35%) cases per year. Of all the TBM cases, 23.2% patients were known case of HIV while 1.45% diagnosed as HIV later. TBM is a disease with poor prognosis as the consequence of the half of the affected patient is death or severe disability which is evidenced by 42.7% patients passed away. TBM imposes a great challenge in both diagnosis and management, as most affected patients will be left with severe long-term complications even with treatment. It is important to understand the epidemiology and characteristics of tuberculous meningitis in Malaysia to improve the management and enhance the control of this deadly disease.