Evidence map›Paper›PMID 23963469›Full record

SynthesisJournal of neurology2014

A 43-year systematic review and meta-analysis: case-fatality and risk of death among adults with tuberculous meningitis in Africa.

Yohannes W Woldeamanuel, Belaineh Girma

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Journal of neurology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
32citing papers in PubMed, 4 pooled it
2.9field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

32 citing papers in PubMed, 4 syntheses or guidelines pooled it, 51 citations in OpenAlex.

  1. Pooled it
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  12. Article
  13. Fujifilm SILVAMP TB LAM Assay on Cerebrospinal Fluid for the Detection of Tuberculous Meningitis in Adults With Human Immunodeficiency Virus.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021
    Article
  14. Article
  15. Article
  16. Article
  17. Article
  18. Tuberculosis deaths are predictable and preventable: Comprehensive assessment and clinical care is the key.Journal of clinical tuberculosis and other mycobacterial diseases · 2020
    Article
  19. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors at 1 institution in 1 country.

Yohannes W WoldeamanuelDepartment of Neurology, Addis Ababa University Faculty of Medicine, P.O.Box 2739, Addis Ababa, Ethiopia, yohannes.woldeamanuel@gmail.com.
Belaineh Girma
Addis Ababa University · ET

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Tuberculous meningitis (TBM) is a preventable and curable common health problem among African adults. Poor nutrition, poverty, household crowding, drug resistant tuberculosis (TB) strains, AIDS, and malfunctioning TB control programs are important risk factors. We conducted a systematic review and meta-analysis of published literature reporting case-fatalities of TBM among adults in African countries from 1970 till date. A PubMed search identified relevant papers. Employed terms include 'adult tuberculous meningitis' AND 'tuberculosis Africa'. PRISMA review guidelines were applied. Adult TBM case-fatalities, odds ratio (OR), relative risk (RR), forest-plot meta-analysis for weighted OR and RR, funnel plots, L'Abbé plots, meta-regressed bubble plots, and inter-study homogeneity were computed. Among 15 studies included, adult TBM occurred in up to 28 % of all meningitis forms with case-fatality of 60 % (inverse-variance weighted 54 %). Fixed-effect meta-analysis revealed weighted OR and RR of adult TBM fatalities to be 4.37 (95 % CI 3.92, 4.88) and 2.53 (95 % CI 2.38, 2.69), respectively. Inter-study homogeneity was reliable, regional representativeness was adequate allowing generalizability, and funnel-plots behaved symmetrically with insignificant inconsistency. All cases were initiated with anti-TB medication, while some had 'breakthrough' TBM. In Africa, adult TBM has a significant public health importance with a very high fatality which has remained stagnant for the past half-century. This reflects ongoing low quality of medical care at facilities where lengthy referrals end up. Community-based studies can reveal higher unaccounted morbidity, accrued disability, and larger mortality. Improving access points for early TB management at community-level, developing health infra-structure for comprehensive case management at facility-level, and poverty reduction can help combat this multi-faceted problem--whose reduction can in return help fight poverty.

Indexed as

AdultAfricaCase-Control StudiesCause of DeathHIV InfectionsHumansMortalityRisk FactorsTuberculosis, Meningeal

Identifiers

PMID23963469
OpenAlexW1965226852

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.