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Application of Cerebrospinal Fluid Host Protein Biosignatures in the Diagnosis of Tuberculous Meningitis in Children from a High Burden Setting
Joint Authors
Walzl, Gerhard
Stanley, Kim
Manyelo, Charles M.
Solomons, Regan S.
Snyders, Candice I.
Manngo, Portia M.
Mutavhatsindi, Hygon
Kriel, Belinda
Chegou, Novel N.
Source
Issue
Vol. 2019, Issue 2019 (31 Dec. 2019), pp.1-11, 11 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2019-04-16
Country of Publication
Egypt
No. of Pages
11
Main Subjects
Abstract EN
Background.
The diagnosis of tuberculous meningitis (TBM) especially in children is challenging.
New tests are urgently needed for the diagnosis of the disease, especially in resource-limited settings.
Methods.
We collected cerebrospinal fluid (CSF) samples from children presenting with symptoms requiring investigation for meningitis at a tertiary hospital in Cape Town, South Africa.
Children were later classified as TBM or no TBM using published case definitions.
Using a multiplex platform, we investigated the concentrations of biomarkers comprising a previously established 3-marker biosignature (VEGF, IL-13, and LL-37) and other potentially useful host biomarkers as diagnostic candidates for TBM.
Findings.
Out of 47 children, age, 3 months to 13 years, 23 were diagnosed with TBM and six (16%) were HIV-infected.
We validated the previously identified CSF biosignature (sensitivity of 95.7% (95% CI, 79.0-99.2%) and specificity of 37.5% (95% CI, 21.2-57.3%)).
However, substitution of IL-13 and LL-37 with IFN-γ and MPO, respectively, resulted in improved accuracy (area under the ROC curve AUC=0.97, 95% CI, 0.92-1.00, up to 91.3% (21/23) sensitivity and up to 100% (24/24) specificity).
An alternative four-marker biosignature (sICAM-1, MPO, CXCL8, and IFN-γ) also showed potential, with an AUC of 0.97.
Conclusion.
We validated a previously identified CSF biosignature and showed that refinement of this biosignature by incorporation of other biomarkers diagnosed TBM with high accuracy.
Incorporation of these biomarkers into a point-of-care or bedside diagnostic test platform may result in the improved management of TBM in children.
American Psychological Association (APA)
Manyelo, Charles M.& Solomons, Regan S.& Snyders, Candice I.& Manngo, Portia M.& Mutavhatsindi, Hygon& Kriel, Belinda…[et al.]. 2019. Application of Cerebrospinal Fluid Host Protein Biosignatures in the Diagnosis of Tuberculous Meningitis in Children from a High Burden Setting. Mediators of Inflammation،Vol. 2019, no. 2019, pp.1-11.
https://search.emarefa.net/detail/BIM-1193290
Modern Language Association (MLA)
Manyelo, Charles M.…[et al.]. Application of Cerebrospinal Fluid Host Protein Biosignatures in the Diagnosis of Tuberculous Meningitis in Children from a High Burden Setting. Mediators of Inflammation No. 2019 (2019), pp.1-11.
https://search.emarefa.net/detail/BIM-1193290
American Medical Association (AMA)
Manyelo, Charles M.& Solomons, Regan S.& Snyders, Candice I.& Manngo, Portia M.& Mutavhatsindi, Hygon& Kriel, Belinda…[et al.]. Application of Cerebrospinal Fluid Host Protein Biosignatures in the Diagnosis of Tuberculous Meningitis in Children from a High Burden Setting. Mediators of Inflammation. 2019. Vol. 2019, no. 2019, pp.1-11.
https://search.emarefa.net/detail/BIM-1193290
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1193290