Knowledge gaps and research priorities in tuberculous meningitis.
Knowledge gaps and research priorities in tuberculous meningitis.
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DOI：
10.12688/wellcomeopenres.15573.1
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发表时间：
2019-01-01
影响因子：
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通讯作者：
Thwaites, Guy E
中科院分区：
文献类型：
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作者：
Seddon, James A;Wilkinson, Robert;Thwaites, Guy E
脑膜炎（TBM）是最严重和致残的结核病（TB）形式，占全球TB病例的约1-5%，儿童死亡率约为20%，合并感染人类免疫缺陷病毒的患者死亡率高达60%，即使在接受治疗的患者中。相对而言，TBM研究的卓越中心很少，因此，该领域将受益于更大的协调，宣传，合作和早期数据共享。为此，我们在2009年、2015年和2019年召集了TBM国际研究联盟，汇集了来自五大洲的约50名研究人员。最近一次会议于2019年3月1日和2日在印度勒克瑙举行。会议期间，研究人员和临床医生介绍了他们专业领域的最新情况，并介绍了该领域的知识差距和研究重点。会议期间进行了讨论，随后由一个核心编写小组编写了一份关于流行病学、发病机理、诊断、抗菌治疗、宿主导向治疗、重症监护和实施科学等七个领域内的知识差距和研究优先事项的综合报告。这些文件已分发给整个联合体，供其提供书面意见和反馈。编写小组之间进行了进一步的讨论，以就一系列优先事项达成共识。这篇文章总结了该联盟就未满足的需求和未来研究的优先事项达成的共识，这种被忽视的，往往是致命的疾病。
Tuberculous meningitis (TBM) is the most severe and disabling form of tuberculosis (TB), accounting for around 1-5% of the global TB caseload, with mortality of approximately 20% in children and up to 60% in persons co-infected with human immunodeficiency virus even in those treated. Relatively few centres of excellence in TBM research exist and the field would therefore benefit from greater co-ordination, advocacy, collaboration and early data sharing. To this end, in 2009, 2015 and 2019 we convened the TBM International Research Consortium, bringing together approximately 50 researchers from five continents. The most recent meeting took place on 1 st and 2 nd March 2019 in Lucknow, India. During the meeting, researchers and clinicians presented updates in their areas of expertise, and additionally presented on the knowledge gaps and research priorities in that field. Discussion during the meeting was followed by the development, by a core writing group, of a synthesis of knowledge gaps and research priorities within seven domains, namely epidemiology, pathogenesis, diagnosis, antimicrobial therapy, host-directed therapy, critical care and implementation science. These were circulated to the whole consortium for written input and feedback. Further cycles of discussion between the writing group took place to arrive at a consensus series of priorities. This article summarises the consensus reached by the consortium concerning the unmet needs and priorities for future research for this neglected and often fatal disease.