Technical Cooperation for the Strengthening of Comprehensive Care and Collaborative Activities Towards the Elimination of AIDS Mortality in Ecuador.
Tuberculosis (TB) poses a significant global health challenge, with tuberculous meningitis (TBM) standing out as the most severe form, characterized by a high mortality rate and long-term disability. Annually, TBM affects over 100,000 individuals, with a mortality rate reaching 50%, particularly among those co-infected with HIV-1.
The diagnosis of TBM is intricate due to nonspecific clinical manifestations, insensitive laboratory techniques, and delays in disease confirmation. Microbiological diagnosis hinges on isolating Mycobacterium tuberculosis from cerebrospinal fluid (CSF). Recent advancements, including Xpert Ultra and point-of-care LAM testing, show promise for prompt diagnosis, but careful consideration is essential, given certain limitations associated with these tests.
Challenges in achieving optimal drug levels in the cerebrospinal fluid hinder antitubercular regimens, prompting trials to explore increased rifampicin doses, adjunctive treatments like linezolid or fluoroquinolones, and the combination of aspirin with corticosteroids to enhance outcomes.
Maintaining a high index of suspicion is crucial, considering the difficulties in diagnosing TBM and the limited efficacy of current therapeutic options. Addressing these challenges is imperative to improve the diagnosis and treatment of TBM, thereby reducing the associated mortality and long-term disability.
Date
Thrusday, 29 February 2024
Time
11:00 am - 01:00 pm. Ecuador Time
Organizers
Event convened by PAHO/WHO and Ministry of Public Health of Ecuador
Objetive
Update the comprehensive management of meningeal tuberculosis, in general and among people living with HIV, sharing best practices to reduce mortality and sequalae.
Agenda
11:00 am - 11:05 am Welcome Remarks & Attendance Record
Ministry of Public Health
11:05 am -11:10 am Introduction of speakers
Omar Sued, PAHO
11:10 am -11:25 am Burden of meningeal TB disease in the Ecuador
Ministry of Public Health
11:25 am -12:00 pm Clinical presentation, diagnosis and treatment of meningeal tuberculosis
Professor Dr. Robert J. Wilkinson
12:00 pm -12:30 pm Meningeal TB among HIV individuals, experience in the Region
Dr. Jose Vidal
12:30 pm -12:55 pm Questions and answer and clinical case comments.
Professor Dr. Robert J. Wilkinson
Dr. Jose Vidal
12:55 pm - 01:00 pm Conclusions and closure
PAHO Ecuador
