Urinary markers of Mycobacterium tuberculosis and dysbiosis in paediatric tuberculous meningitis cases undergoing treatment.

Both metabolites showed similar linear trends – TBM stage 1 stayed elevated throughout treatment, whereas TBM stages 2 and 3 showed a decreasing trend, approaching control levels by T6. 4HHA and PA are components of host tyrosine–phenylalanine (aromatic amino acids) metabolism, and metabolites of microbial origin. 4HHA and PA have been identified as a major consequence of perturbed metabolism associated with diseases linked with alterations to the gut-microbiome [ 8 , 40 , 64 – 66 ].

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