ArticleThe European respiratory journal2020
Performance of immune-based and microbiological tests in children with tuberculosis meningitis in Europe: a multicentre Paediatric Tuberculosis Network European Trials Group (ptbnet) study.
Article in The European respiratory journal, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 3 of them syntheses that pooled it.
What it found
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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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 3 syntheses or guidelines pooled it, 30 citations in OpenAlex.
- Potential biomarkers for tuberculous meningitis diagnosis using metabolomics and proteomics: a systematic review.BMC infectious diseases · 2025Pooled it
- Microbiological diagnosis and mortality of tuberculosis meningitis: Systematic review and meta-analysis.PloS one · 2023Pooled it
- Central nervous system infections in patients with systemic lupus erythematosus: a systematic review and meta-analysis.Lupus science & medicine · 2022Pooled it
- The Utility of a Three-gene Host Response to Discriminate Tuberculous Meningitis From Other Infections in Children.The Pediatric infectious disease journal · 2026Article
- Clinical scoring systems for diagnosing tuberculous meningitis: A systematic review.World journal of critical care medicine · 2026Article
- Case Report: Tuberculous meningitis presenting with multifocal cerebral infarction and hydrocephalus in a toddler.Frontiers in pediatrics · 2026Article
- Clinical and Evolutive Features of Tuberculous Meningitis in an Immunosuppressed Adolescent During the COVID 19 Pandemic.Biomedicines · 2025Article
- Sensitivity of Immunodiagnostic Tests in Localized Versus Disseminated Tuberculosis-A Systematic Review of Individual Patient Data.Tropical medicine and infectious disease · 2025Review
- Clinical standards for drug-susceptible TB in children and adolescents.The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2023Article
- Commercially available CD4 + and CD8 + IFN-γ release assays combined with an HBHA-induced IGRA improve the characterization of the tuberculosis spectrum and monitoring of treatment in children.European journal of pediatrics · 2023Article
- [Tuberculosis-Update 2022].Monatsschrift Kinderheilkunde : Organ der Deutschen Gesellschaft fur Kinderheilkunde · 2023Article
- Review
- Epidemiology of extrapulmonary tuberculosis among pediatric inpatients in mainland China: a descriptive, multicenter study.Emerging microbes & infections · 2022Article
- QIAreach QuantiFERON-TB for the diagnosis ofThe European respiratory journal · 2022Article
- Treatment Outcomes of Childhood Tuberculous Meningitis in a Real-World Retrospective Cohort, Bandung, Indonesia.Emerging infectious diseases · 2022Article
- Strengthening Tuberculosis Services for Children and Adolescents in Low Endemic Settings.Pathogens (Basel, Switzerland) · 2022Article
- The Sensitivity of Diagnostic Criteria of Marais S, et al. in Confirmed Childhood Tuberculous Meningitis.Frontiers in pediatrics · 2022Article
- QuantiFERON-TB Gold Plus Assay in Patients With Latent vs. Active Tuberculosis in a Low Incidence Setting: Level of IFN-γ, CD4/CD8 Responses, and Release of IL-2, IP-10, and MIG.Frontiers in microbiology · 2022Article
- COVID-19 in children and adolescents in Europe: a multinational, multicentre cohort study.The Lancet. Child & adolescent health · 2020Article
- Immunological Evaluation for Personalized Interventions in Children with Tuberculosis: Should It Be Routinely Performed?Journal of immunology research · 2020Article
Corrections and comments
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Authors and funding
20 authors at 15 institutions in 8 countries.
Funding
Abstract
introductionTuberculous meningitis (TBM) is often diagnostically challenging. Only limited data exist on the performance of interferon-γ release assays (IGRA) and molecular assays in children with TBM in routine clinical practice, particularly in the European setting.
methodsMulticentre, retrospective study involving 27 healthcare institutions providing care for children with tuberculosis (TB) in nine European countries.
resultsOf 118 children included, 54 (45.8%) had definite, 38 (32.2%) probable and 26 (22.0%) possible TBM; 39 (33.1%) had TBM grade 1, 68 (57.6%) grade 2 and 11 (9.3%) grade 3. Of 108 patients who underwent cranial imaging 90 (83.3%) had at least one abnormal finding consistent with TBM. At the 5-mm cut-off the tuberculin skin test had a sensitivity of 61.9% (95% CI 51.2-71.6%) and at the 10-mm cut-off 50.0% (95% CI 40.0-60.0%). The test sensitivities of QuantiFERON-TB and T-SPOT.TB assays were 71.7% (95% CI 58.4-82.1%) and 82.5% (95% CI 58.2-94.6%), respectively (p=0.53). Indeterminate results were common, occurring in 17.0% of QuantiFERON-TB assays performed. Cerebrospinal fluid (CSF) cultures were positive in 50.0% (95% CI 40.1-59.9%) of cases, and CSF PCR in 34.8% (95% CI 22.9-43.7%). In the subgroup of children who underwent tuberculin skin test, IGRA, CSF culture and CSF PCR simultaneously, 84.4% had at least one positive test result (95% CI 67.8%-93.6%).
conclusionsExisting immunological and microbiological TB tests have suboptimal sensitivity in children with TBM, with each test producing false-negative results in a substantial proportion of patients. Combining immune-based tests with CSF culture and CSF PCR results in considerably higher positive diagnostic yields, and should therefore be standard clinical practice in high-resource settings.
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Registered trials
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