TB meningitis - University College London and London School of Hygiene & Tropical Medicine

SURE + DP: Improving diagnosis and prognosis for paediatric tuberculous meningitis through the SURE treatment trial

Meningitis Now Research - TB meningitis - University College London

Researchers

Dr Robindra Basu Roy (Chief Investigator), Dr Suzanne Anderson, Dr Chishala Chabala, Professor Diana Gibb, Dr Hilda Mujuru, Dr James Seddon,  Dr Eric Wobudeya 

Research Institutions

MRC Clinical Trials Unit at University College London and London School of Hygiene & Tropical Medicine

Background

Tuberculosis (TB) is a very common infectious disease worldwide. Although usually thought of as a lung disease, the bacteria that cause TB can also cause meningitis (TBM). This is the most severe form of TB, killing 20 - 40% of people affected and leaving many survivors with life-long disabilities. Young children are particularly at risk.

Early and improved diagnosis of TBM is vital so that the correct treatment starts as soon as possible and outcomes are improved. 

A clinical trial of short intensified TBM treatment in children (SURE), co-ordinated and sponsored by the UK Medical Research Council (MRC) Clinical Trials Unit at UCL, is currently underway in Uganda, Zambia, Zimbabwe, India and Vietnam.

What this research team planned to do

In July 2019, Meningitis Now awarded full funding to this exciting project.

Aim 1: This research team has a unique opportunity to use samples of blood, cerebrospinal fluid (CSF) and urine from children diagnosed with TBM who are taking part in the African centres of the SURE trial. In addition to this, the team will recruit a control group of children from the same centres who have similar symptoms but are not thought to have TBM. 

Aims 2 & 3: Cutting-edge laboratory techniques will test and compare blood, CSF and urine samples from both groups of children. 

The results of these investigations could help to develop better diagnostic tests for TBM and also help to identify where adjustments in treatment and care could improve outcomes.

Impact of COVID-19 on funding for this study

This study was proposed to start in April 2020, but as a consequence of the negative financial impact of COVID-19, full funding had to be withdrawn.

However, in order not to miss the unique opportunity of recruiting a “non-TBM” control group of children alongside the SURE treatment trial, both Meningitis Now and Dr Basu Roy worked hard to secure funding for Aim 1 of the original award.

By March 2021, enough funding had been jointly secured to enable Aim 1 to proceed. A small amount of additional funding will also allow for pilot analysis of samples, the results of which will help to secure the additional funding needed for the full analysis proposed in the original grant application.

How this research will help fight meningitis

This research will enable the evaluation and development of novel diagnostics for TBM in children; hopefully leading to improved tests and outcomes.

Progress so far

COVID-19 not only affected the funding for this particular study but also had knock-on effects on the parent SURE trial. All of the research ethics and regulatory approvals from the UK, Uganda, Zambia, and Zimbabwe are in place to start recruiting the “non-TBM” group of children from spring 2022.

Publications

Basu Roy, R.; Bakeera-Kitaka, S.; Chabala, C.; Gibb, D.M.; Huynh, J.; Mujuru, H.; Sankhyan, N.; Seddon, J.A.; Sharma, S.; Singh, V.; Wobudeya, E.; Anderson, S.T. Defeating Paediatric Tuberculous Meningitis: Applying the WHO “Defeating Meningitis by 2030: Global Roadmap”. Microorganisms 2021, 9, 857. 

https://doi.org/10.3390/microorganisms9040857 

Help support this research

This research is only made possible by the generous support of people like YOU. Help us continue by donating, or raising funds for our work. On behalf of everyone who will benefit, now and in the future, thank you.

More information 

If you would like more information about this project, or our research in general, please contact research@meningitisnow.org