Table 1.
Characteristics of Studies Meeting Inclusion Criteria
| Author | Year | Country | TB Burden | Study Design | N | HIV | Positive AFB | TBM by Ref | Reference standard1 | Technique2 | Volume3 | Time/Fields4 | Sensitivity % | Specificity % |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Lin(18) | 1995 | Taiwan | Low | Cohort | 45* | 0 | 0 | 20 | CSF Profile, Symptoms | ND | ND | ND | 0 | 100 |
| Desai(19) | 2002 | India | High | Cohort | 105 | 0 | 2 | 33 | NAAT | Concentration (details ND), ZN and auramine smears | ND | ND | 6 | 99 |
| Thwaites(10) | 2004 | Vietnam | High | Cohort | 330 | 14 | 73 | 132 | Culture, AFB | Centrifuged 3000g ×15 min. | 1.5mL HIV−, 4.0mL HIV+ | Up to 50 min. | 55 | 100 |
| Dil-Afroze(20) | 2008 | India | High | Case Control | 47 | 0 | 0 | 27 | CSF Profile, Symptoms | ND | ND** | ND | 0 | 50 |
| Mendes(21) | 2010 | Portugal | Low | Cohort | 107 | 0 | 1 | 17 | Culture, AFB | ND | ND | ND | 6 | 100 |
| Narotam(22) | 2012 | India | High | Cohort | 64 | 0 | 2 | 32 | Culture | ND | ND | ND | 6 | 100 |
| Feng(23)*** | 2014 | China | High | Cohort | 280 | 0 | 8 | 240 | Definite, Probable, or Possible TBM | Centrifuged 3000g ×10 min. | 2mL | 300 fields | 3 | 100 |
| Neelakantan(24) | 2014 | India | High | Cohort | 281 | 0 | 23 | 32 | Culture | Centrifuged 3000g × 10 min., ZN and auramine smears | ND | ND | 72 | 86 |
| Bahr(25) | 2015 | Uganda | Low | Cohort | 107 | 105 | 4 | 18 | Definite TBM | Centrifuged 3000g × 15min. | 0.1mL of 4mL re-suspended sample | ND | 22 | 100 |
| Park(26) | 2016 | South Korea | Low | Cohort | 147**** | 0 | 3 | 38 | Definite or Probable TBM | ND | ND | ND | 8 | 100 |
| Sun(27) | 2017 | China | High | Cohort | 200 | 0 | 5 | 172 | Definite TBM | ND | 1mL | ND | 3 | 100 |
Composite reference standard separated by comma
Technique=any technique used to potentially increase sensitivity
Volume/fields=median volume in mL used per smear/fields examined per slide
Time=time in minutes on average spent examining each specimen
45 participants but with 47 samples (two participants with multiple samples from different time points), all four samples from these two participants were negative.
Not specifically discussed, 2–3mL used for NAAT, culture, and AFB smear
A modified ZN using 0.5mL, 100g ×5 min. in a cytospin chamber with poly-L lysine slides and examined 300 fields was completed in this study but not included in the meta-analysis as our focus was to quantify conventional ZN staining.
Though 276 samples were included in the study, only 147 had AFB smear completed
N=total cohort number; HIV=number people living with HIV among the cohort; AFB = acid fast bacilli; Positive AFB: number of cases positive by AFB smear among those positive by the reference standard; TBM=TB meningitis, TBM by Ref.=cases that qualifying as TBM per the reference standard in that study; CSF=cerebrospinal fluid;; CSF Profile = Combination of CSF protein, white blood cell count, white blood cell differential, and/or glucose; Culture = M. tuberculosis culture growth in CSF;; NAAT = Nucleic acid amplification test (e.g. PCR); Symptoms = B symptom evaluation; Definite, probable, and possible TBM refer to Marais criteria categories
ND=not discussed; min.= minutes