A clinical practice guideline for tuberculous meningitis

Area of Science:

• Infectious Diseases
• Neurology
• Public Health

Background:

• Tuberculous meningitis is a severe form of tuberculosis with high mortality and disability rates.
• Current international guidelines for tuberculous meningitis management are outdated.
• Optimal diagnosis and treatment strategies are urgently needed.

Purpose of the Study:

• To conduct a systematic review of evidence for tuberculous meningitis management.
• To develop practice guidance for diagnosis, chemotherapy, and supportive care.
• To identify knowledge and evidence gaps for future research.

Main Methods:

• Systematic review using Population, Intervention, Comparator, Outcome (PICO) format.
• Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach for evidence quality.
• Inclusion of international consortium representatives.

Main Results:

• Evidence-based recommendations for tuberculous meningitis diagnosis and treatment.
• Expert opinion integrated into practice guidance.
• Identification of substantial knowledge and evidence gaps.

Conclusions:

• There is a critical need for updated international guidelines for tuberculous meningitis.
• The systematic review provides a foundation for optimal patient care.
• Future research priorities are highlighted to address current evidence deficits.