Evidence map›Paper›PMID 41322245›Full record

ArticleOpen forum infectious diseases2025

Epstein-Barr Virus Central Nervous System Infections and Mortality Risk in Patients Presenting With Suspected Meningitis: Results From the Botswana National Meningitis Survey and the Harare Meningitis Aetiology Study.

Jayne Ellis, James Milburn, Kebatshabile Ngoni, Christopher G Williams, Charles Muthoga, Taddy Mwarumba, Ezekiel Gwakuba, George Manenji, Rachita Suresh, Tichoaya Machiya and 24 more

Abstract read
In one paragraph

Article in Open forum infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. 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. 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

34 authors.

Jayne EllisClinical Research Department, London School of Hygiene and Tropical Medicine, London, United Kingdom.ORCID https://orcid.org/0000-0002-7009-9144
James MilburnClinical Research Department, London School of Hygiene and Tropical Medicine, London, United Kingdom.ORCID https://orcid.org/0000-0001-9885-6103
Kebatshabile NgoniBotswana Harvard Health Partnership, Gaborone, Botswana.
Christopher G WilliamsBotswana Harvard Health Partnership, Gaborone, Botswana.
Charles MuthogaBotswana Harvard Health Partnership, Gaborone, Botswana.
Taddy MwarumbaDepartment of Internal Medicine, University of Zimbabwe, Harare, Zimbabwe.ORCID https://orcid.org/0009-0001-6943-4515
Ezekiel GwakubaBotswana Harvard Health Partnership, Gaborone, Botswana.
George ManenjiDepartment of Internal Medicine, University of Zimbabwe, Harare, Zimbabwe.
Rachita SureshBotswana Harvard Health Partnership, Gaborone, Botswana.
Tichoaya MachiyaPrincess Marina Hospital Laboratory, Gaborone, Botswana.
Janet ThubukaPrincess Marina Hospital Laboratory, Gaborone, Botswana.
Cassie NorthcottBotswana Harvard Health Partnership, Gaborone, Botswana.
James PenneyBotswana Harvard Health Partnership, Gaborone, Botswana.ORCID https://orcid.org/0009-0001-0056-4194
Matthew KinsellaBotswana Harvard Health Partnership, Gaborone, Botswana.ORCID https://orcid.org/0000-0002-1715-3201
Imogen MechieBotswana Harvard Health Partnership, Gaborone, Botswana.ORCID https://orcid.org/0000-0002-6310-6342
Samuel EnsorBotswana Harvard Health Partnership, Gaborone, Botswana.ORCID https://orcid.org/0000-0001-8456-9576
Tshepo LeemeBotswana Harvard Health Partnership, Gaborone, Botswana.
Leah OwenBotswana-UPenn Partnership, Gaborone, Botswana.
Hannah BartonBotswana-UPenn Partnership, Gaborone, Botswana.ORCID https://orcid.org/0000-0002-6788-4213
Keatlaretse SiamisangBotswana Harvard Health Partnership, Gaborone, Botswana.
Mark W TenfordeDepartment of Medicine, University of Washington School of Medicine, Seattle, Washington, USA.ORCID https://orcid.org/0000-0002-8702-8393
William HurtBotswana-UPenn Partnership, Gaborone, Botswana.ORCID https://orcid.org/0000-0003-3803-9165
Ronan DoyleClinical Research Department, London School of Hygiene and Tropical Medicine, London, United Kingdom.ORCID https://orcid.org/0000-0001-5001-1945
Daniel GrintDepartment of Infectious Disease Epidemiology and International Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.ORCID https://orcid.org/0000-0001-8001-6544
Síle F MolloyInstitute for Infection and Immunity, City St George's University of London, London, United Kingdom.
Thomas S HarrisonInstitute for Infection and Immunity, City St George's University of London, London, United Kingdom.
David M GoldfarbDepartment of Pathology and Laboratory Medicine, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Madisa MineNational Health Laboratory, Gaborone, Botswana.
Margaret MokomaneUniversity of Botswana, Gaborone, Botswana.
Gift NgwendeDepartment of Internal Medicine, University of Zimbabwe, Harare, Zimbabwe.
Lenon GwaunzaDepartment of Internal Medicine, University of Zimbabwe, Harare, Zimbabwe.
Tiny MazhaniDepartment of Infectious Disease Epidemiology and International Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.ORCID https://orcid.org/0000-0001-9112-2174
Chiratidzo NdhlovuDepartment of Internal Medicine, University of Zimbabwe, Harare, Zimbabwe.
Joseph N JarvisClinical Research Department, London School of Hygiene and Tropical Medicine, London, United Kingdom.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Epstein-Barr virus (EBV) central nervous system (CNS) infection in immunocompromised hosts and among meningitis cohorts is well recognized. The clinical significance of EBV CNS infection, however, is poorly understood. Methods: Data were collected as part of the Botswana National Meningitis Survey and the Harare Meningitis Aetiology Study. The prevalence of EBV CNS infection (EBV DNA detected in cerebrospinal fluid [CSF] by means of quantitative polymerase chain reaction) was determined, alongside associations with baseline covariates and the in-hospital mortality rate. Results: A total of 581 participants with suspected meningitis were recruited. Of these, 54% were male, the median age (interquartile range) was 38 (29-46) years, and 76% were persons living with human immunodeficiency virus (HIV). Cryptococcal meningitis was the most common microbiologically confirmed infectious meningitis (12.0%), and 6.4% of participants had definite tuberculous meningitis. EBV CNS infection was common (26% [152 of 581]) and was associated with older age, being HIV positive, and CSF pleocytosis ( Conclusions: EBV CNS infection was common among our cohort, and it was strongly associated with CSF pleocytosis. Following multivariable analyses, EBV CNS infection overall was not associated with in-hospital mortality rate. EBV CNS infection in the context of meningitis is most likely a "bystander" virus that reflects heightened CSF inflammation.

Indexed as

cryptococcalEpstein-Barr virusHIVmeningitistuberculosis

Identifiers

PMID41322245
PMCPMC12661572

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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.