SynthesisTuberculosis (Edinburgh, Scotland)2022
Cerebrospinal fluid AFB smear in adults with tuberculous meningitis: A systematic review and diagnostic test accuracy meta-analysis.
Synthesis in Tuberculosis (Edinburgh, Scotland), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 2 of them syntheses that pooled it.
What it found
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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.
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
23 citing papers in PubMed, 2 syntheses or guidelines pooled it, 25 citations in OpenAlex.
- A clinical practice guideline for tuberculous meningitis.The Lancet. Infectious diseases · 2026Guideline
- Diagnostic value of the cerebrospinal fluid lipoarabinomannan assay for tuberculous meningitis: a systematic review and meta-analysis.Frontiers in public health · 2023Pooled it
- Article
- Diagnosis of Tuberculous Meningitis: Integrating Clinical Assessment and Molecular Diagnostics.Diagnostics (Basel, Switzerland) · 2026Review
- Drug-Resistant Tuberculous Meningitis (DR-TBM) in a Low-Incidence Setting: Two Cases and an Evidence Review Highlighting Key Advances and Knowledge Gaps in Clinical Management.Open forum infectious diseases · 2026Article
- Optimizing pathological diagnosis of tuberculosis: qPCR outperforms acid-fast staining in formalin-fixed paraffin-embedded tissues and enables resistance profiling.Frontiers in medicine · 2026Article
- CSF carnitine is a potential biomarker in paediatric tuberculous meningitis.Scientific reports · 2025Article
- Development and validation of a diagnostic model for tuberculous meningitis based on laboratory data.Frontiers in cellular and infection microbiology · 2025Article
- Molecular diagnostics in cerebrospinal fluid for the diagnosis of central nervous system infections.Clinical microbiology reviews · 2024Review
- Tuberculous meningitis leading to stroke: a case report.Annals of medicine and surgery (2012) · 2024Article
- Nanopore-targeted sequencing (NTS) for intracranial tuberculosis: a promising and reliable approach.Annals of clinical microbiology and antimicrobials · 2024Article
- Using cerebrospinal fluid nanopore sequencing assay to diagnose tuberculous meningitis: a retrospective cohort study in China.BMJ open · 2024Article
- A comparison of clinical features between neurobrucellosis and tuberculous meningitis.BMC neurology · 2024Article
- The value of nanopore sequencing as a diagnostic tool in tuberculous meningitis: A protocol of systematic review and meta-analysis.PloS one · 2024Article
- Tuberculous meningitis diagnosis and treatment: classic approaches and high-throughput pathways.Frontiers in immunology · 2024Review
- Editorial: Advances in the management of tuberculosis meningitis.Frontiers in immunology · 2024Article
- Enhancing the Accuracy of Peripheral Pulmonary Tuberculosis Diagnosis: A Comparative Evaluation of CapitalBioInfection and drug resistance · 2024Article
- Advancing Diagnosis and Treatment in People Living with HIV and Tuberculosis Meningitis.Current HIV/AIDS reports · 2023Review
- Review
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundCerebrospinal fluid (CSF) Ziehl-Neelsen acid-fast bacilli (AFB) smear is a rapid, cheap, widely available test for tuberculous meningitis (TBM). Yet, reported test sensitivity is highly variable. We performed a systematic review and meta-analysis for CSF AFB smear vs. other mycobacterial tests to diagnose TBM.
methodsWe searched MEDLINE and Embase for studies reporting sensitivity and specificity of AFB smear against mycobacterial tests (reference standard) in adults (≥15 years) with suspected TBM. We used the QUADAS-2 tool to assess risk of bias. We estimated pooled sensitivity and specificity of AFB smear versus the reference standard using random-effects bivariate modeling. We used the I
resultsOf 981 articles identified, 11 were eligible for inclusion with a total of 1713 participants. Seven studies were from high-TB burden settings and 4 from low-TB burden settings. The pooled sensitivity and specificity of CSF AFB smear were 8% (95%CI 3-21) and 100% (95%CI 90-100), with substantial heterogeneity in diagnostic performance (I
conclusionCSF AFB smear has poor sensitivity in most settings. If other more sensitive tests are available, those should be used preferentially rather than CSF AFB smear.
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Registered trials
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.