Evidence map›Paper›PMID 31189584›Full record

ArticleJournal of clinical microbiology2019

Prospective Cohort Study on Performance of Cerebrospinal Fluid (CSF) Xpert MTB/RIF, CSF Lipoarabinomannan (LAM) Lateral Flow Assay (LFA), and Urine LAM LFA for Diagnosis of Tuberculous Meningitis in Zambia.

Omar K Siddiqi, Gretchen L Birbeck, Musie Ghebremichael, Eugene Mubanga, Shawn Love, Clayton Buback, Barry Kosloff, Helen Ayles, Masharip Atadzhanov, Keertan Dheda and 1 more

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of clinical microbiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed, 6 pooled it
6.8field-weighted citation impact, top 3% 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

22 citing papers in PubMed, 6 syntheses or guidelines pooled it, 44 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Article
  8. Article
  9. Article
  10. Review
  11. Article
  12. Article
  13. Review
  14. Article
  15. Article
  16. 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
  17. Central nervous system tuberculosis.Current opinion in neurology · 2021
    Review
  18. Value of lipocalin 2 as a potential biomarker for bacterial meningitis.Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases · 2020
    Article
  19. Review
  20. Review
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

11 authors at 8 institutions in 4 countries.

Omar K SiddiqiGlobal Neurology Program, Department of Neurology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA osiddiqi@bidmc.harvard.edu igor_koralnik@rush.edu.ORCID 0000-0001-9696-563X
Gretchen L BirbeckDepartment of Internal Medicine, University of Zambia School of Medicine, Lusaka, Zambia.
Musie GhebremichaelHarvard Medical School and Ragon Institute of MGH, MIT and Harvard, Boston, Massachusetts, USA.
Eugene MubangaDepartment of Internal Medicine, University of Zambia School of Medicine, Lusaka, Zambia.
Shawn LoveDepartment of Neurology, University of California Los Angeles, Los Angeles, California, USA.
Clayton BubackDepartment of Neurology, University of Rochester, Rochester, New York, USA.
Barry KosloffZambart, Lusaka, Zambia.
Helen AylesZambart, Lusaka, Zambia.
Masharip AtadzhanovDepartment of Internal Medicine, University of Zambia School of Medicine, Lusaka, Zambia.
Keertan DhedaCentre for Lung Infection and Immunity, Division of Pulmonology, Department of Medicine, University of Cape Town, Cape Town, South Africa.
Igor J KoralnikDepartment of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA osiddiqi@bidmc.harvard.edu igor_koralnik@rush.edu.
University of Zambia · ZMLondon School of Hygiene & Tropical Medicine · GBBeth Israel Deaconess Medical Center · USHarvard University · USRush University Medical Center · USSouth African Medical Research Council · ZAUniversity of California, Los Angeles · USUniversity of Rochester · US

Funding

Novel CSF Diagnostics and Genotype Markers of Tuberculous Meningitis in ZambiaK23NS084054 · NINDS · BETH ISRAEL DEACONESS MEDICAL CENTER · PI SIDDIQI, OMAR KHALIK · 2014 to 2018
$910k
NINDS NIH HHS K23 NS084054
6 · The paper itself

Abstract

Tuberculous meningitis (TBM) is a devastating infection of the central nervous system lacking an adequate point-of-care diagnostic test. We conducted a prospective cohort study of 550 Zambian adults with suspected TBM to determine the diagnostic accuracy of cerebrospinal fluid (CSF) Xpert MTB/RIF, CSF lipoarabinomannan (LAM), urine LAM, CSF total protein, and CSF glucose compared with the gold standard of CSF culture. We categorized patients with a positive CSF tuberculosis (TB) culture as definite TBM. We also assessed inpatient and 1-year mortality on definite TBM patients when CSF Xpert MTB/RIF results were available in real time to treating physicians relative to a historical comparison cohort in whom Xpert results were not available in real time. Of the 550 patients, 474 (86.2%) were HIV-infected and 105/550 (19.1%) had definite TBM based on a positive CSF culture. The sensitivity/specificity of the diagnostic tests were CSF Xpert MTB/RIF, 52.9%/94.2%; CSF LAM, 21.9%/94.2%; urine LAM, 24.1%/76.1%; and CSF glucose <40 mg/dl, and total protein, >100 mg/dl, 66.3%/90%. A model including CSF Xpert MTB/RIF, CSF LAM, CSF glucose, and CSF total protein demonstrated an area under the receiver operating curve of 0.90. The inpatient and 1-year mortality for definite TBM was 43% and 57%, respectively. There was low sensitivity for the diagnosis of TBM across all diagnostics tests. CSF Xpert MTB/RIF and CSF LAM are highly specific for the diagnosis of TBM. Despite the use of Xpert MTB/RIF for diagnostic purpose in real time, TBM was still associated with a high mortality in Zambian patients.

Indexed as

AdultFemaleGlucoseHIV InfectionsHumansImmunoassayLipopolysaccharidesMaleMiddle AgedMolecular Diagnostic TechniquesMycobacterium tuberculosisProspective StudiesReagent StripsReproducibility of ResultsSensitivity and SpecificityTuberculosis, MeningealGlucoselipoarabinomannanLipopolysaccharidesReagent StripsAfricahuman immunodeficiency virusLAMtuberculous meningitisXpert MTB/RIFZambia

Identifiers

PMID31189584
PMCPMC6663887
OpenAlexW2950609773

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.