SynthesisTropical medicine & international health : TM & IH2021
Diagnostic accuracy of Xpert MTB/RIF for tuberculous meningitis: systematic review and meta-analysis.
Synthesis in Tropical medicine & international health : TM & IH, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 25 citations in OpenAlex.
- Pathogen and host biomarkers to aid early diagnosis and prognosis of tuberculous meningitis.Infection · 2026Article
- Basal Ganglia Ischemic Stroke as Sentinel Sign for Pediatric Tuberculous Meningitis in an Immunocompetent Child: A Case Report.Pediatric reports · 2026Article
- Clinical Profile and Prognostic Determinants in Central Nervous System Tuberculosis: An Observational Study from a Tertiary Neurology Centre in India.Annals of Indian Academy of Neurology · 2026Article
- Diagnosis of Tuberculous Meningitis: Integrating Clinical Assessment and Molecular Diagnostics.Diagnostics (Basel, Switzerland) · 2026Review
- Anti-TB treatment outcomes in TB meningitis: A systematic review and meta-analysis.New microbes and new infections · 2025Review
- Combined cerebrospinal fluid sCD163, MMP-9, with serum NCAM1 protein levels for predicting the prognosis of patients with tuberculous meningitis.Scientific reports · 2025Article
- Tuberculous ventriculitis as a devastating neurological manifestation of immune reconstitution inflammatory syndrome: A case report in immunocompetent patient.International journal of surgery case reports · 2024Article
- The diagnostic potential of urine in paediatric patients undergoing initial treatment for tuberculous meningitis.Scientific reports · 2024Article
- Advancing Diagnosis and Treatment in People Living with HIV and Tuberculosis Meningitis.Current HIV/AIDS reports · 2023Review
- Review
- The Role of GeneXpertTropical medicine and infectious disease · 2023Article
- Recent advances in microbiological and molecular biological detection techniques of tuberculous meningitis.Frontiers in microbiology · 2023Review
- Diagnostic and therapeutic approach to chronic meningitis in Brazil: a narrative review.Arquivos de neuro-psiquiatria · 2022Review
- Tuberculous Meningitis in Children: A Forgotten Public Health Emergency.Frontiers in neurology · 2022Article
- Tuberculous Meningitis: Impact of Timing of Treatment Initiation on Mortality.Open forum infectious diseases · 2021Article
Corrections and comments
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Authors and funding
9 authors at 4 institutions in 3 countries.
Funding
Abstract
objectiveThis systematic review evaluated the diagnostic accuracy of Xpert MTB/RIF to detect tuberculous meningitis (TBM).
methodsPubMed and five other databases were systematically searched through March 2019. All studies evaluating diagnostic accuracy of Xpert MTB/RIF on cerebrospinal fluid (CSF) samples were included. Reference standards were definitive or definite plus probable TBM. The quality of studies was assessed by the QUADAS-2 tool. We performed bivariate random-effects meta-analysis and calculated summary diagnostic statistics.
resultsWe identified 30 studies (n = 3972 participants), including 5 cohort studies and 25 cross-sectional studies. Reference standards were definite TB (n = 28 studies) or definite plus probable TBM (n = 6 studies). The pooled Xpert MTB/RIF sensitivity was 85% (95% CI, 70-93%), and specificity was 98% (95% CI, 97-99%) with a negative likelihood ratio of 0.15 (95% CI, 0.04-0.27) for definite TBM. For probable TBM cases, pooled sensitivity was 81% (95% CI, 66-90%), and specificity was 99% (95% CI, 97-99%). For both reference standard types, meta-analyses showed a C-statistic area under the curve of 0.98. The QUADAS-2 tool revealed low risk of bias as well as low concerns regarding applicability. Methodological heterogeneity was high among studies.
conclusionsXpert MTB/RIF showed high accuracy for TBM diagnosis, but a negative Xpert MTB/RIF test does not rule out TBM. Repeat Xpert testing may be necessary. In clinical practice, Xpert MTB/RIF adds speed and sensitivity when compared to classic TBM diagnostic methods or previous commercial nucleic acid amplification techniques. More studies and better strategies for rapidly confirming a diagnosis of TBM in children are urgently needed.
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