Background Meningeal tuberculosis (MTB) is the most lethal and disabling form of Mycobacterium Tuberculosis infection. In Colombia, it represents the second most frequent extrapulmonary location. Co-infection with the Human Immunodeficiency Virus (HIV) is one of the factors that most impacts their clinical results. Therefore, in this article we present the experience of 10 years of managing patients with MTB, with and without HIV coinfection. Methods A retrospective observational study was conducted between January 2008 and December 2018, with clinical information from patients diagnosed with MTB at Teaching Hospital Fundación Valle del Lili. Using absolute and relative frequency tables, sociodemographic, clinical characteristics and treatment outcomes were described, according to HIV infection status. P values < 0.05 were taken as significant and 95% confidence intervals were used for comparison of proportions. Results 61 patients with MTB diagnosed were enrolled. They represented 6.43% of all TB locations in the institutional registry. HIV coinfection was found in 26.2% of cases (n=16). Most of patients were men (65.6%), from urban areas (78.7%), and a median age of 39 years. Acute and subacute evolution of the infection was observed in half of the patients (50.8%). Also 85% presented some degree of neurological impairment. Bacteriological demonstration was achieved in 60.6% of all cases. 88% received drugs for sensitive TB, for a median of 9.5 months, and 52.5% received concomitant steroids drugs. Of the 36 subjects with information about their outcome, 42.6% were successful at treatment, 1 failed in the non-HIV group and 9 died (1 with HIV). 77% of all deaths were associated with TB. Conclusion MTB generates a significant burden disease. The characteristics of its insidious clinical presentation and the difficulty in achieving bacteriological demonstration in all patients make its timely diagnostic and therapeutic approach challenging. Disclosures All Authors: No reported disclosures

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Background In Directly Observed Treatment (DOT) monitoring strategy for the treatment of tuberculosis (TB), the patient has to travel daily to the health institution to take the TB medication. Although has been usefulness, this strategy increases the catastrophic costs of the disease, rising the probability of rejection, abandonment, and failure to treatment. Therefore, a monitoring strategy was implemented through video calls phone known as Synchronous Video Observed Therapy (S-VOT), to document the experience and its results in a series of patients from a low-middle income country. Methods A prospective case series study was conducted involving 23 TB patients managed with standard treatment, who were supervised through daily video call phone, during 2019, Cali-Colombia. Adherence to VOT strategy and treatment were evaluated, as well as patient characteristics, adverse drug effects, perception and costs. Categorical variable data were summarized in absolute and relative frequency tables. Quantitative variables were described with median and Interquartile range. Proportional differences were calculated with Z test, risk opportunities and difference of medians with Mann Whitney’s U test were performed. We take p values < 0.05 as significant. Results Adherence to S-VOT monitoring strategy was 99.8% in first phase of treatment and 98.2% in second phase. All patients completed treatment, achieving 100% cure criteria in patients with pulmonary TB. Most adverse drug effects were reported on first month (31.6%, p=0.003). Skin changes were the most frequent complaint at the beginning of management (16.4%) and epigastralgia at the end (20%). The likelyhood of adverse effects was significantly reduced when patients started maintenance phase on third month (OR: 0.29, p = 0.0003). The experience of the strategy was generally positive for patients. Time savings was major advantage. Travel costs in S-VOT were lower than DOT for patients, as well as the daily time investment in TB treatment. Conclusion S-VOT strategy was well tolerated and accepted by all patients, allowing an excellent level of adherence, with reduction in travel costs and investment of time for treatment. S-VOT is proposed as a viable alternative to DOT in selected patients. Disclosures All Authors: No reported disclosures