Improving Technology to Diagnose Tuberculous Meningitis: Are We There Yet? (2024)

Ssebambulidde, K., Gakuru, J., Ellis, J., Cresswell, F. V., & Bahr, N. C. (2022). Improving Technology to Diagnose Tuberculous Meningitis: Are We There Yet? Frontiers in Neurology, 13, Article 892224. https://doi.org/10.3389/fneur.2022.892224

Improving Technology to Diagnose Tuberculous Meningitis: Are We There Yet? / Ssebambulidde, Kenneth; Gakuru, Jane; Ellis, Jayne et al.
In: Frontiers in Neurology, Vol. 13, 892224, 30.05.2022.

Research output: Contribution to journal › Review article › peer-review

Ssebambulidde, K, Gakuru, J, Ellis, J, Cresswell, FV & Bahr, NC 2022, 'Improving Technology to Diagnose Tuberculous Meningitis: Are We There Yet?', Frontiers in Neurology, vol. 13, 892224. https://doi.org/10.3389/fneur.2022.892224

Ssebambulidde K, Gakuru J, Ellis J, Cresswell FV, Bahr NC. Improving Technology to Diagnose Tuberculous Meningitis: Are We There Yet? Frontiers in Neurology. 2022 May 30;13:892224. doi: 10.3389/fneur.2022.892224

Ssebambulidde, Kenneth ; Gakuru, Jane ; Ellis, Jayne et al. / Improving Technology to Diagnose Tuberculous Meningitis : Are We There Yet?. In: Frontiers in Neurology. 2022 ; Vol. 13.

@article{682d63c8712e461daa80871f90d201f6,

title = "Improving Technology to Diagnose Tuberculous Meningitis: Are We There Yet?",

abstract = "Diagnosis of tuberculous meningitis (TBM) remains challenging due to a paucity of high-performance diagnostics. Even those that have reasonable sensitivity are not adequate to {\textquoteleft}rule out' TBM. Therefore, a combination of clinical factors alongside microbiological, molecular, and radiological investigations are utilized, depending on availability. A low threshold for starting empiric therapy in the appropriate clinical scenario remains crucial for good outcomes in many cases. Herein, we review the current TBM diagnostics landscape with a focus on limitations frequently encountered, such as diagnostic test performance, cost, laboratory infrastructure, and clinical expertise. Though molecular technologies, particularly GeneXpert MTB/Rif Ultra, have been a step forward, diagnosis of TBM remains difficult. We also provide an overview of promising technologies, such as cerebrospinal fluid (CSF) lactate, a new lipoarabinomannan test (FujiLAM), metagenomic next-generation sequencing, and transcriptomics that may further improve our TBM diagnostic capacity and lead to better outcomes.",

keywords = "TB meningitis, cerebrospinal fluid, diagnostic testing, molecular testing, tuberculosis, tuberculous meningitis",

author = "Kenneth Ssebambulidde and Jane Gakuru and Jayne Ellis and Cresswell, {Fiona V.} and Bahr, {Nathan C.}",

note = "Publisher Copyright: Copyright {\textcopyright} 2022 Ssebambulidde, Gakuru, Ellis, Cresswell and Bahr.",

year = "2022",

month = may,

day = "30",

doi = "10.3389/fneur.2022.892224",

language = "English (US)",

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T1 - Improving Technology to Diagnose Tuberculous Meningitis

T2 - Are We There Yet?

AU - Ssebambulidde, Kenneth

AU - Gakuru, Jane

AU - Ellis, Jayne

AU - Cresswell, Fiona V.

AU - Bahr, Nathan C.

N1 - Publisher Copyright:Copyright © 2022 Ssebambulidde, Gakuru, Ellis, Cresswell and Bahr.

PY - 2022/5/30

Y1 - 2022/5/30

N2 - Diagnosis of tuberculous meningitis (TBM) remains challenging due to a paucity of high-performance diagnostics. Even those that have reasonable sensitivity are not adequate to ‘rule out' TBM. Therefore, a combination of clinical factors alongside microbiological, molecular, and radiological investigations are utilized, depending on availability. A low threshold for starting empiric therapy in the appropriate clinical scenario remains crucial for good outcomes in many cases. Herein, we review the current TBM diagnostics landscape with a focus on limitations frequently encountered, such as diagnostic test performance, cost, laboratory infrastructure, and clinical expertise. Though molecular technologies, particularly GeneXpert MTB/Rif Ultra, have been a step forward, diagnosis of TBM remains difficult. We also provide an overview of promising technologies, such as cerebrospinal fluid (CSF) lactate, a new lipoarabinomannan test (FujiLAM), metagenomic next-generation sequencing, and transcriptomics that may further improve our TBM diagnostic capacity and lead to better outcomes.

AB - Diagnosis of tuberculous meningitis (TBM) remains challenging due to a paucity of high-performance diagnostics. Even those that have reasonable sensitivity are not adequate to ‘rule out' TBM. Therefore, a combination of clinical factors alongside microbiological, molecular, and radiological investigations are utilized, depending on availability. A low threshold for starting empiric therapy in the appropriate clinical scenario remains crucial for good outcomes in many cases. Herein, we review the current TBM diagnostics landscape with a focus on limitations frequently encountered, such as diagnostic test performance, cost, laboratory infrastructure, and clinical expertise. Though molecular technologies, particularly GeneXpert MTB/Rif Ultra, have been a step forward, diagnosis of TBM remains difficult. We also provide an overview of promising technologies, such as cerebrospinal fluid (CSF) lactate, a new lipoarabinomannan test (FujiLAM), metagenomic next-generation sequencing, and transcriptomics that may further improve our TBM diagnostic capacity and lead to better outcomes.

KW - TB meningitis

KW - cerebrospinal fluid

KW - diagnostic testing

KW - molecular testing

KW - tuberculosis

KW - tuberculous meningitis

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