A systematic review: the role of neuroinflammation as a pathway to injury in traumatic brain injury

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dc.contributor.advisorSchutz, Charlotte
dc.contributor.advisorMeintjes, Graeme
dc.contributor.authorVermeulen, Marcia
dc.date.accessioned2025-10-01T12:06:17Z
dc.date.available2025-10-01T12:06:17Z
dc.date.issued2025
dc.date.updated2025-10-01T09:18:27Z
dc.description.abstractBackground: HIV-associated tuberculosis has a high mortality. Chest x-rays are an adjunct diagnostic tool for tuberculosis but has high inter-reader variability, which may be reduced with chest x-ray scoring systems. We analysed and scored chest x-rays of hospitalised patients with HIV-associated tuberculosis and assessed the relationship of these chest x-ray scores with 12-week mortality and biomarkers of tuberculosis dissemination. Methods: In this cohort study, the chest x-rays of adult patients, admitted with a new diagnosis of microbiologically confirmed HIV-associated tuberculosis were scored using the Timika scoring system. We excluded patients without a valid test result for the 3 biomarkers of tuberculosis dissemination (urine lipoarabinomannan, TB blood culture and urine Xpert); valid chest x-ray; or who were lost to follow up. Results: Amongst 364 included participants, 73 (20%) died and 291 (80%) survived. Median age was 36 years and median CD4 count 57cells/mm3. 25% of participants had normal chest x-rays. No association was found between chest x-ray score and dissemination score. Higher chest x-ray score was associated with higher hazards of death using a multivariate analysis: every 10-point increase in chest x-ray score resulted in 9% increased hazards of death. Conclusion: In this cohort, a higher Timika chest x-ray score was associated with higher hazards of death at 12-weeks.
dc.identifier.apacitationVermeulen, M. (2025). <i>A systematic review: the role of neuroinflammation as a pathway to injury in traumatic brain injury</i>. (). University of Cape Town ,Faculty of Health Sciences ,Department of Public Health and Family Medicine. Retrieved from http://hdl.handle.net/11427/41941en_ZA
dc.identifier.chicagocitationVermeulen, Marcia. <i>"A systematic review: the role of neuroinflammation as a pathway to injury in traumatic brain injury."</i> ., University of Cape Town ,Faculty of Health Sciences ,Department of Public Health and Family Medicine, 2025. http://hdl.handle.net/11427/41941en_ZA
dc.identifier.citationVermeulen, M. 2025. A systematic review: the role of neuroinflammation as a pathway to injury in traumatic brain injury. . University of Cape Town ,Faculty of Health Sciences ,Department of Public Health and Family Medicine. http://hdl.handle.net/11427/41941en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Vermeulen, Marcia AB - Background: HIV-associated tuberculosis has a high mortality. Chest x-rays are an adjunct diagnostic tool for tuberculosis but has high inter-reader variability, which may be reduced with chest x-ray scoring systems. We analysed and scored chest x-rays of hospitalised patients with HIV-associated tuberculosis and assessed the relationship of these chest x-ray scores with 12-week mortality and biomarkers of tuberculosis dissemination. Methods: In this cohort study, the chest x-rays of adult patients, admitted with a new diagnosis of microbiologically confirmed HIV-associated tuberculosis were scored using the Timika scoring system. We excluded patients without a valid test result for the 3 biomarkers of tuberculosis dissemination (urine lipoarabinomannan, TB blood culture and urine Xpert); valid chest x-ray; or who were lost to follow up. Results: Amongst 364 included participants, 73 (20%) died and 291 (80%) survived. Median age was 36 years and median CD4 count 57cells/mm3. 25% of participants had normal chest x-rays. No association was found between chest x-ray score and dissemination score. Higher chest x-ray score was associated with higher hazards of death using a multivariate analysis: every 10-point increase in chest x-ray score resulted in 9% increased hazards of death. Conclusion: In this cohort, a higher Timika chest x-ray score was associated with higher hazards of death at 12-weeks. DA - 2025 DB - OpenUCT DP - University of Cape Town KW - TB KW - HIV LK - https://open.uct.ac.za PB - University of Cape Town PY - 2025 T1 - A systematic review: the role of neuroinflammation as a pathway to injury in traumatic brain injury TI - A systematic review: the role of neuroinflammation as a pathway to injury in traumatic brain injury UR - http://hdl.handle.net/11427/41941 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/41941
dc.identifier.vancouvercitationVermeulen M. A systematic review: the role of neuroinflammation as a pathway to injury in traumatic brain injury. []. University of Cape Town ,Faculty of Health Sciences ,Department of Public Health and Family Medicine, 2025 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/41941en_ZA
dc.language.isoen
dc.language.rfc3066eng
dc.publisher.departmentDepartment of Public Health and Family Medicine
dc.publisher.facultyFaculty of Health Sciences
dc.publisher.institutionUniversity of Cape Town
dc.subjectTB
dc.subjectHIV
dc.titleA systematic review: the role of neuroinflammation as a pathway to injury in traumatic brain injury
dc.typeThesis / Dissertation
dc.type.qualificationlevelMasters
dc.type.qualificationlevelMPH
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