Brain Infection Diagnosis and Care Dramatically Improved in LMICs by Targeted Intervention

LIVERPOOL, UK – A groundbreaking intervention package, implemented across hospitals in Brazil, India, and Malawi, has significantly boosted the diagnosis and management of life-threatening brain infections, according to a new study published in The Lancet. Researchers from the University of Liverpool, in collaboration with international partners, spearheaded the initiative, addressing critical gaps in care within low- and middle-income countries (LMICs).

The study, conducted in 13 hospitals, focused on improving the diagnosis and treatment of acute brain infections such as encephalitis and meningitis, conditions that pose a severe threat, particularly in resource-constrained settings.

The intervention package comprised several key components:

• A Clinical Algorithm: A clear, step-by-step guide for clinicians to manage suspected brain infections in the crucial initial hours and days, outlining necessary tests and treatments.
• A Lumbar Puncture Pack: Providing essential equipment and guidance for proper cerebrospinal fluid (CSF) collection and testing, overcoming common challenges.
• A Panel of Laboratory Tests: Enabling timely and accurate detection of a wide range of pathogens, addressing limitations in test availability and sequencing.
• Comprehensive Training: Equipping clinicians and lab staff with enhanced knowledge and skills for effective diagnosis and management.

The results of the intervention were remarkable. The proportion of patients receiving a syndromic diagnosis (confirmation of a brain infection) increased from 77% to 86%, while the microbiological diagnosis rate (identification of the specific pathogen) rose from 22% to 30%. Furthermore, the intervention improved lumbar puncture procedures, optimized initial treatment, and enhanced patient recovery.

“Following patients and their cerebrospinal fluid samples through the hospital system, we tailored our intervention to address key gaps in care. The results speak for themselves: better diagnosis, better management, and ultimately, better outcomes for patients,” said Dr. Bhagteshwar Singh, lead author and Clinical Research Fellow at the University of Liverpool.

Professor Tom Solomon, corresponding author and Chair of Neurological Science at the University of Liverpool, emphasized the global impact of the findings. “We increased microbiological diagnoses by one-third across very diverse countries, which has profound implications for treatment and public health globally.”

The intervention was co-designed with local clinicians, lab specialists, hospital administrators, researchers, and policymakers, ensuring its feasibility and sustainability. Professor Priscilla Rupali from Christian Medical College, Vellore, India, highlighted the integration of the findings into India’s national Brain Infection Guidelines.

The intervention package is available as a free toolkit for adaptation in various settings at: https://braininfectionsglobal.tghn.org/resources/brain-infections-global-tools/.

This initiative aligns with the World Health Organization’s (WHO) efforts to combat meningitis and reduce the burden of encephalitis worldwide.

Disclaimer: This news article is based on information provided from the source material. Medical information provided here should not be considered as medical advice. Always consult with a qualified healthcare professional for diagnosis and treatment of any medical condition.¹ Results obtained in this study may not be representative of all settings.