Validation of The Child TB LP Clinical Decision Tool For Diagnosis of Tubercular Meningitis in Children Aged 6 Months-12 Years

Abstract Background: 50% cases of tubercular meningitis result in death or disability. To ensure optimum outcomes it is important to diagnose it early. Current diagnostic tests, such as CBNAAT, not available everywhere and don't offer good sensitivity. Goenka et al developed ‘CHILD TB LP clinical decision tool’. It has a sensitivity 100% and specificity of 90%. In our nation, TBM is a highly prevalent ailment, and the prognosis of patients is greatly impacted by prompt diagnosis. Thus, the purpose of this study was to further assess this clinical score. Methods: This is an observational cross sectional study. This study aims to validate the "CHILD TB LP clinical decision tool" for the diagnosis of tubercular meningitis in children between the ages of three months and twelve years, as well as to establish a correlation between the tool and radiological findings in cases of tubercular meningitis. It includes 57 people who met the inclusion criteria. After completing the evaluation and filling out a proforma, participants were divided into two groups: probable TBM (score >= 4) and no TBM (scoring <4). Participants were followed for confirming microbiologically confirmed TBM and then tool’s sensitivity, specificity, PPV and NPV calculated. Results: The "Child TB LP Clinical Decision tool" had a sensitivity of 100% and a specificity of 30.6%. Significant correlations were found between tubercular meningitis and the CSF protein, CSF CBNAAT, chest radiography, mantoux, and computed tomography/magnetic resonance imaging. Conclusion: The "CHILD TB LP Clinical Decision Tool" is an excellent tool for TBM screening and the commencement of anti-tubercular therapy. CT/MRI Brain can be included in the ‘CHILD TB LP Clinical Decision Tool’ where resources are readily accessible. Further research is required on this.