Conference Abstract | Volume 8, Abstract NACNDC/19JASH00050 (Poster) | Published: 01 Dec 2025
Joel Okot1,&, Mark Okwir2, David Meya3, Paul Bohjanen3, Abigail Link4
1Lira Regional Referral Hospital, Lira, Uganda, 2Lira University, Lira, Uganda, 3Makerere University, Infectious Disease Institute, Kampala, Uganda, 4University of Rochester, Rochester, New York, USA
&Corresponding author: Joel Okot, Lira Regional Referral Hospital, Lira, Uganda, Email: okotjoel512@gmail.com
Received: 11 Sep 2025, Accepted: 20 Oct 2025, Published: 01 Dec 2025
Domain: Infectious Disease Epidemiology
Keywords: Tuberculous meningitis, Outcome, Lira Northern Uganda
©Joel Okot et al. Journal of Interventional Epidemiology and Public Health (ISSN: 2664-2824). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Cite this article: Joel Okot et al., Tuberculous meningitis outcomes among patients admitted at Lira Regional Referral Hospital, Northern Uganda: A case series. Journal of Interventional Epidemiology and Public Health. 2025;8(ConfProc6):00050. https://doi.org/10.37432/JIEPH-CONFPRO6-00050
Tuberculosis (TB) is among the leading causes of mortality and efforts to end TB by 2030 are underway by World Health Organization and the Ugandan Government. TB is a common opportunistic infections affecting people living with HIV (PLWH) infection, with tuberculous meningitis (TBM) being most severe and often fatal form. In sub-Saharan countries, such as Uganda, TBM diagnosis and treatment poses significant challenges with high mortality, especially among PLWH. This case series analyzes the burden and prognosis among TBM patients admitted at Lira Regional Referral Hospital, Northern Uganda between September 2021 and January 2025.
A retrospective case series study was conducted on secondary data from 20 adult patients diagnosed with TBMutilizing CSF GeneXpert Ultra between September 2021 and January 2025. Data were compiled from patient hospital files and clinical records. Descriptive analyses were conducted on demographics, antiretroviral therapy (ART) history, CSF GeneXpert diagnostics, CD4 cell counts and mortality outcomes.
Among the 20 participants identified with TBM, 65% (13/20) were male with a mean age of 35.3 years (SD 10.1), and mean CD4 cell count of 150.9 cell/mm3. In-patient mortality was 60% (12/20) and eight (40%) 408/20) were discharged home, and overall, short and long-term mortality was 70% (14/20). However, 25% (2/8) died from home within four months of discharge. Poor adherence to antiretroviral therapy (ART) and TB medications (36%), malnutrition (36%), delayed diagnosis, delayed initiation of ART and low CD4 < 100 cells/mm3 contributed to mortality.
This case series reveals that TBM prognosis is poor with a high mortality. Patients died had poor adherence to (ART), delayed initiation of ART regiment, and malnutrition. Intensive adherence counselling is highly recommended to newly diagnosed HIV patients to reduce the burden of TBM. Additionally, further research to establish outpatient care and the factors related to post-hospital mortality.
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