ArticlePloS one2017
Goal directed therapy for suspected acute bacterial meningitis in adults and adolescents in sub-Saharan Africa.
Article in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 3 of them syntheses that pooled it.
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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.
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Who cites it
8 citing papers in PubMed, 3 syntheses or guidelines pooled it, 19 citations in OpenAlex.
- Sex differences in bacterial meningitis and associations with socioeconomic indicators: a systematic review and meta-analysis with metaregression.BMJ global health · 2025Pooled it
- Global Case Fatality of Bacterial Meningitis During an 80-Year Period: A Systematic Review and Meta-Analysis.JAMA network open · 2024Pooled it
- Mortality from HIV-associated meningitis in sub-Saharan Africa: a systematic review and meta-analysis.Journal of the International AIDS Society · 2020Pooled it
- Enhanced detection of bacterial etiologies, antibiotic resistance profile, and treatment outcomes of meningitis patients in Ethiopia: a prospective cross-sectional study.BMC microbiology · 2025Article
- A multifaceted intervention to improve diagnosis and early management of hospitalised patients with suspected acute brain infections in Brazil, India, and Malawi: an international multicentre intervention study.Lancet (London, England) · 2025Observational
- Knowledge and perceptions of antimicrobial resistance and antimicrobial stewardship among staff at a national cancer referral center in Uganda.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2022Article
- CSF Levels of Elongation Factor Tu Is Associated With Increased Mortality in Malawian Adults WithFrontiers in cellular and infection microbiology · 2020Article
- Rapid response to meningococcal disease cluster in Foya district, Lofa County, Liberia January to February 2018.The Pan African medical journal · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors at 3 institutions in 3 countries.
Funding
Abstract
backgroundMortality from acute bacterial meningitis (ABM) in sub-Saharan African adults and adolescents exceeds 50%. We tested if Goal Directed Therapy (GDT) was feasible for adults and adolescents with clinically suspected ABM in Malawi. MATERIALS AND
methodsSequential patient cohorts of adults and adolescents with clinically suspected ABM were recruited in the emergency department of a teaching hospital in Malawi using a before/after design. Routine care was monitored in year one (P1). In year two (P2), nurses delivered protocolised GDT (rapid antibiotics, airway support, oxygenation, seizure control and fluid resuscitation) to a second cohort. The primary endpoint was composite mean number of clinical goals attained. Secondary endpoints were individual goals attained and death or disability from proven or probable ABM at day 40.
results563 patients with suspected ABM were enrolled in the study; 273 were monitored in P1; 290 patients with suspected ABM received GDT in P2. 61% were male, median age 33 years and 90% were HIV co-infected. ABM was proven or probable in 132 (23%) patients. GDT attained more clinical goals compared to routine care: composite mean number of goals in P1 was 0·55 vs. 1·57 in P2 GDT (p<0·001); Death or disability by day 40 from proven or probable ABM occurred in 29/57 (51%) in P1 and 38/60 (63%) in P2 (p = 0·19).
conclusionNurse-led GDT in a resource-constrained setting was associated with improved delivery of protocolised care. Outcome was unaffected.
trial registrationwww.isrctn.com ISRCTN96218197.
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