{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T21:00:17Z","timestamp":1769720417910,"version":"3.49.0"},"reference-count":37,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2020,9,23]],"date-time":"2020-09-23T00:00:00Z","timestamp":1600819200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["K08-AI139371"],"award-info":[{"award-number":["K08-AI139371"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Tuberculous meningitis (TBM) is a medical emergency, yet there are no standardized treatment guidelines for the medical or neurosurgical management of these patients and little data on neurocritical care. We conducted an international survey to understand current medical and neurosurgical TBM management and resource availability to provide baseline data needed for future multicenter trials addressing unanswered clinical research questions and the establishment of standardized guidelines.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>An online survey of 77 questions covering medical and neurosurgical TBM management aimed at clinicians\/nurses treating TBM was distributed as an anonymous link through email invitation, international organizations\u2019 membership distribution, and direct links on organizational webpages or social media. The survey remained open for 5 months. Data were summarized with frequencies and percentages.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The survey had 222 responses from 43 countries representing 6 continents. Most respondents were from tertiary care facilities, with broad access to medical and neurosurgical resources. There was significant heterogeneity in general supportive care, and TBM-specific management demonstrated considerable divergence from current standard-of-care practices. The lack of standardized guidelines was identified as a major challenge in TBM management. General and neurocritical care were largely absent. Resources for bedside supportive care and noninvasive monitoring were broadly accessible.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>These findings suggest that current TBM management could be improved by the establishment of internationally accepted treatment guidelines based on available evidence, and that numerous centers have resources available to participate in future multicenter trials, even for basic interventions, that may further improve patient outcomes globally.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ofid\/ofaa445","type":"journal-article","created":{"date-parts":[[2020,9,23]],"date-time":"2020-09-23T06:14:45Z","timestamp":1600841685000},"source":"Crossref","is-referenced-by-count":7,"title":["International Survey Reveals Opportunities to Improve Tuberculous Meningitis Management and the Need for Standardized Guidelines"],"prefix":"10.1093","volume":"7","author":[{"given":"Elizabeth W","family":"Tucker","sequence":"first","affiliation":[{"name":"Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine , Baltimore, Maryland, USA"},{"name":"Center for Tuberculosis Research, Johns Hopkins University School of Medicine , Baltimore, Maryland, USA"},{"name":"Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine , Baltimore, Maryland, USA"},{"name":"Division of Pediatric Critical Care, Johns Hopkins All Children\u2019s Hospital , St. Petersburg, Florida, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suzaan","family":"Marais","sequence":"additional","affiliation":[{"name":"Division of Neurology, Department of Medicine and Neuroscience Institute, University of Cape Town , Cape Town, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James A","family":"Seddon","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Imperial College London , London, United Kingdom"},{"name":"Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Stellenbosch University , Cape Town, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reinout","family":"van Crevel","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center , Nijmegen, the Netherlands"},{"name":"Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford , Oxford, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmad Rizal","family":"Ganiem","sequence":"additional","affiliation":[{"name":"Department of Neurology, Hasan Sadikin Hospital, Faculty of Medicine Universitas Padjadjaran , Bandung, Indonesia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rovina","family":"Ruslami","sequence":"additional","affiliation":[{"name":"Department of Neurology, Hasan Sadikin Hospital, Faculty of Medicine Universitas Padjadjaran , Bandung, Indonesia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wenhong","family":"Zhang","sequence":"additional","affiliation":[{"name":"Departments of Infectious Diseases, Huashan Hospital, Fudan University , Shanghai, China"},{"name":"National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University , Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Feng","family":"Sun","sequence":"additional","affiliation":[{"name":"Departments of Infectious Diseases, Huashan Hospital, Fudan University , Shanghai, China"},{"name":"National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University , Shanghai, 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