Evidence map›Paper›PMID 39286031›Full record

ArticleOpen forum infectious diseases2024

Utility of Cerebrospinal Fluid Unstimulated Interferon-Gamma (IRISA-TB) as a Same-Day Test for Tuberculous Meningitis in a Tuberculosis-Endemic, Resource-Poor Setting.

Philippa Randall, Junior Mutsvangwa, Marriott Nliwasa, Lindsay Wilson, Beauty Makamure, Edson Makambwa, Richard Meldau, Keertan Dheda, Shungu Munyati, Omar Siddiqi and 2 more

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In one paragraph

Article in Open forum infectious diseases, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Reply to Adzemovic et al.Open forum infectious diseases · 2025
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors.

Philippa RandallCentre for Lung Infection and Immunity, Department of Medicine, University of Cape Town and Division of Pulmonology, University of Cape Town Lung Institute, Observatory, Cape Town, South Africa.ORCID https://orcid.org/0000-0002-5490-0536
Junior MutsvangwaBiomedical Research and Training Institute, Harare, Zimbabwe.
Marriott NliwasaCollege of Medicine, University of Malawi, Blantyre, Malawi.
Lindsay WilsonCentre for Lung Infection and Immunity, Department of Medicine, University of Cape Town and Division of Pulmonology, University of Cape Town Lung Institute, Observatory, Cape Town, South Africa.
Beauty MakamureBiomedical Research and Training Institute, Harare, Zimbabwe.
Edson MakambwaCentre for Lung Infection and Immunity, Department of Medicine, University of Cape Town and Division of Pulmonology, University of Cape Town Lung Institute, Observatory, Cape Town, South Africa.
Richard MeldauCentre for Lung Infection and Immunity, Department of Medicine, University of Cape Town and Division of Pulmonology, University of Cape Town Lung Institute, Observatory, Cape Town, South Africa.
Keertan DhedaCentre for Lung Infection and Immunity, Department of Medicine, University of Cape Town and Division of Pulmonology, University of Cape Town Lung Institute, Observatory, Cape Town, South Africa.ORCID https://orcid.org/0000-0001-7709-5341
Shungu MunyatiBiomedical Research and Training Institute, Harare, Zimbabwe.
Omar SiddiqiDivision of Neuro-Virology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
Elizabeth CorbettCollege of Medicine, University of Malawi, Blantyre, Malawi.
Ali EsmailCentre for Lung Infection and Immunity, Department of Medicine, University of Cape Town and Division of Pulmonology, University of Cape Town Lung Institute, Observatory, Cape Town, South Africa.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Tuberculous meningitis (TBM) mortality is high and current diagnostics perform suboptimally. We evaluated the diagnostic performance of a DNA-based assay (GeneXpert Ultra) against a new same-day immunodiagnostic assay that detects unstimulated interferon-gamma (IRISA-TB). Methods: In a stage 1 evaluation, IRISA-TB was evaluated in biobanked samples from Zambia (n = 82; tuberculosis [TB] and non-TBM), and specificity in a South African biobank (n = 291; non-TBM only). Given encouraging results, a stage 2 evaluation was performed in suspected TBM patients from Zimbabwe and Malawi (n = 668). Patients were classified as having definite, probable or possible TBM, or non-TBM based on their microbiological results, cerebrospinal fluid (CSF) chemistry, and whether they received treatment. Results: In the stage 1 evaluation, sensitivity and specificity of IRISA-TB were 75% and 87% in the Zambian samples, and specificity was 100% in the South African samples. In the stage 2 validation, IRISA-TB sensitivity (95% confidence interval [CI]) was significantly higher than Xpert Ultra (76.2% [55.0%-89.4%] vs 25% [8.9%-53.3%]; Conclusions: As a same-day rule-in test, IRISA-TB had significantly better sensitivity than Xpert Ultra in a TB/HIV-endemic setting. An immunodiagnostic approach to TBM is promising, and further studies are warranted.

Indexed as

accuracydiagnosisGeneXpert Ultrainterferon gammatuberculous meningitis

Identifiers

PMID39286031
PMCPMC11403475

What OpenQuestion holds

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Registered trials

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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.