Evidence map›Paper›PMID 40121439›Full record

Observational studyBMC infectious diseases2025

Clinical utility of the FilmArray® meningitis/encephalitis panel in children with suspected central nervous system infection in a low-resource setting - a prospective study in Southwestern Uganda.

Reza Rasti, Elias Kumbakumba, Deborah Nanjebe, Phuthumani Mlotshwa, Milly Nassejje, John Mzee, Stephen Businge, Gilbert Akankwasa, Dan Nyehangane, Jesper Gantelius and 5 more

Registry-linked trialAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BMC infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03900091 (Paediatric Infections Point-Of-Care), which is not on this map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing 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.

NCT03900091 completednot on this map

Paediatric Infections Point-Of-Care: Point-of-care Approach for Rapid and Easy Meningitis Diagnosis

TypeobservationalSponsorKarolinska InstitutetRan2019 to 2020Enrolled351ConditionsMeningitis, Pediatric Infectious DiseasesArmsMultiplex PCR assay for meningitis, Multiplex vertical flow microarrray assay for meningitis, Profiling of blood proteins by multi-analyte Profiling technology, Typing and whole genome sequencing
3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Trial
  2. Article
  3. Article
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

15 authors.

Reza Rasti *Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden. reza.rasti@ki.se.ORCID http://orcid.org/0000-0001-7816-8338
Elias Kumbakumba *Department of Paediatrics and Child Health, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.
Deborah Nanjebe *Epicentre Mbarara Research Center, Mbarara, Uganda.
Phuthumani MlotshwaDepartment of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
Milly NassejjeDepartment of Paediatrics and Child Health, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.
John MzeeDepartment of Paediatrics and Child Health, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.
Stephen BusingeHoly Innocents Children's Hospital, Mbarara, Uganda.
Gilbert AkankwasaEpicentre Mbarara Research Center, Mbarara, Uganda.
Dan NyehanganeEpicentre Mbarara Research Center, Mbarara, Uganda.
Jesper GanteliusDivision of Nanobiotechnology, Department of Protein Science, Science for Life Laboratory, KTH Royal Institute of Technology, Stockholm, Sweden.
Yap BoumDepartment of Paediatrics and Child Health, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.
Andreas MårtenssonDepartment of Women's and Children's Health, Global Health & Migration Unit, Uppsala University, Uppsala, Sweden.
Juliet Mwanga-AmumpaireDepartment of Paediatrics and Child Health, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.
Tobias Alfvén *Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
Giulia Gaudenzi *Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.

Funding

EIT Health 18373European Research Council 615458Stockholm läns landsting 20150503Stockholm läns landsting 20180292Svenska Läkaresällskapet 935435Vetenskapsrådet 2015-03217Vetenskapsrådet 2019-05170
6 · The paper itself

Abstract

backgroundIn low-resource settings, limited laboratory capacity adds to the burden of central nervous system (CNS) infections in children and spurs overuse of antibiotics. The commercially available BioFire® FilmArray® Meningitis/Encephalitis Panel (FA-ME) with its capability to simultaneously detect 14 pathogens in cerebrospinal fluid (CSF), could potentially narrow such a diagnostic gap.

methodsIn Mbarara, Uganda, we compared clinical utility (clinical turnaround time [cTAT], microbial yield, and influence on patient outcome and antibiotic exposure) of FA-ME with bacterial culture, in children 0-12 years with suspected CNS infection.

resultsOf 212 enrolled children, CSF was sampled from 194. All samples underwent bacterial culture, of which 193 also underwent FA-ME analyses. FA-ME analyses prospectively influenced care for 169 of the 193 patients, and they constituted an 'Index group'. The remaining 43/212 patients constituted a 'Reference group'. Of all 194 CSF-sampled patients, 87% (168) had received antibiotics before lumbar puncture. Median cTAT for FA-ME was 4.2 h, vs. two days for culture. Bacterial yield was 12% (24/193) and 1.5% (3/194) for FA-ME and culture, respectively. FA-ME viral yield was 12% (23/193). Fatality rate was 14% in the Index group vs. 19% in the Reference group (P = 0.20). From clinician receival of FA-ME results, median antibiotic exposure was 6 days for bacteria-negative vs. 13 days for bacteria-positive patients (P = 0.03). Median hospitalization duration was 7 vs. 12 days for FA-ME negative and positive patients, respectively (P < 0.01).

conclusionsIn this setting, clinical FA-ME utility was found in a higher and faster microbial yield and shortened hospitalization and antibiotic exposure of patients without CSF pathology. More epidemiologically customized pathogen panels may increase FA-ME utility locally, although its use in similar settings would require major cost reductions.

trial registrationThe trial was registered with clinicaltrials.gov (NCT03900091) in March 2019, and its protocol was published in November 2020.

Indexed as

Central Nervous System InfectionsEncephalitisMeningitisMolecular Diagnostic TechniquesAnti-Bacterial AgentsBacteriaChildChild, PreschoolFemaleHumansInfantInfant, NewbornMaleProspective StudiesUgandaAnti-Bacterial AgentsCentral nervous system infectionsFilmArrayGlobal healthMeningitisMolecular diagnostic techniquesPaediatrics

Identifiers

PMID40121439
PMCPMC11930002

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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.