{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:00:42Z","timestamp":1786122042857,"version":"build-2736575974"},"reference-count":19,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T00:00:00Z","timestamp":1786060800000},"content-version":"vor","delay-in-days":6,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100021281","name":"Gates Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100021281","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012264","name":"NIH","doi-asserted-by":"publisher","award":["1R01NS129156"],"award-info":[{"award-number":["1R01NS129156"]}],"id":[{"id":"10.13039\/501100012264","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The true burden of tuberculous meningitis (TBM), particularly in low and middle-income countries, is unknown due to imperfect diagnostics. Complete diagnostic autopsy (CDA) to confirm TBM in deceased meningitis patients is uncommon. Minimally invasive tissue sampling (MITS) has been shown to be a viable alternative to CDA to establish infectious etiologies of meningitis. We used MITS to determine the burden of TBM among deceased adult Zambians who presented with meningitis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a prospective cohort study of Zambian adults who presented with symptoms suggestive of TBM, recording whether they had a complete cerebrospinal fluid (CSF) diagnostic assessments during their admission. We followed patients for the outcome of discharge or death. Among those who died, after obtaining consent from the family, we performed MITS, collecting CSF, brain, lung, and liver tissue looking for evidence of Mycobacterium tuberculosis infection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We completed MITS on 50 deceased Zambian adults who presented with meningitis symptoms. Twenty-two cases had a complete antemortem CSF evaluation. Among these cases, 4\/22 (18%) were diagnosed with TBM before death and an additional 2\/22 (9%) were diagnosed with TBM via MITS after death. Twenty-eight deaths occurred in patients with an incomplete or no CSF evaluation. Among these cases, 4\/28 (14%) were diagnosed with TBM via MITS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>MITS can confirm the diagnosis of TBM in deceased meningitis patients. It can be a valuable tool in meningitis surveillance to establish an infectious etiology.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ofid\/ofag394","type":"journal-article","created":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T11:54:57Z","timestamp":1786017297000},"source":"Crossref","is-referenced-by-count":0,"title":["Minimally Invasive Tissue Sampling for Postmortem Diagnosis of Tuberculous Meningitis in Zambian Adults"],"prefix":"10.1093","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9696-563X","authenticated-orcid":false,"given":"Omar K","family":"Siddiqi","sequence":"first","affiliation":[{"name":"Global Neurology Program, Department of Neurology, Beth Israel Deaconess Medical Center , Boston, Massachusetts ,","place":["USA"]},{"name":"Center for Vaccines and Virology Research, Department of Internal Medicine, Beth Israel Deaconess Medical Center , Boston, Massachusetts ,","place":["USA"]},{"name":"Department of Internal Medicine, University of Zambia School of Medicine , Lusaka ,","place":["Zambia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gretchen L","family":"Birbeck","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Rochester , Rochester, New York ,","place":["USA"]},{"name":"Chikankata Epilepsy Care Team, Chikankata Hospital , Mazabuka ,","place":["Zambia"]},{"name":"University Teaching Hospitals Children's Hospital Department of Pediatrics and Child Health, , Lusaka ,","place":["Zambia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0190-8670","authenticated-orcid":false,"given":"Caroline","family":"Kabwe","sequence":"additional","affiliation":[{"name":"Zambart, University of Zambia School of Medicine , Lusaka ,","place":["Zambia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gift","family":"Moonga","sequence":"additional","affiliation":[{"name":"Zambart, University of Zambia School of Medicine , Lusaka ,","place":["Zambia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergio","family":"Muwowo","sequence":"additional","affiliation":[{"name":"University Teaching Hospitals, Adult Hospital , Lusaka ,","place":["Zambia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzyani","family":"Simumba","sequence":"additional","affiliation":[{"name":"University Teaching Hospitals, Adult Hospital , Lusaka ,","place":["Zambia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chola","family":"Mulenga","sequence":"additional","affiliation":[{"name":"Tropical Gastroenterology and Nutrition Group, University of Zambia School of Medicine , Lusaka ,","place":["Zambia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rabson","family":"Mwanza","sequence":"additional","affiliation":[{"name":"University Teaching Hospitals, Adult Hospital , Lusaka 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using minimally invasive autopsies in developing countries","volume":"84","author":"Martinez","year":"2016","journal-title":"Diagn Microbiol Infect Dis"},{"key":"2026080703441228500_ofag394-B7","doi-asserted-by":"crossref","first-page":"e1002431","DOI":"10.1371\/journal.pmed.1002431","article-title":"Validity of a minimally invasive autopsy for cause of death determination in maternal deaths in Mozambique: an observational study","volume":"14","author":"Castillo","year":"2017","journal-title":"PLoS Med"},{"key":"2026080703441228500_ofag394-B8","doi-asserted-by":"crossref","first-page":"e0132057","DOI":"10.1371\/journal.pone.0132057","article-title":"Pathological methods applied to the investigation of causes of death in developing countries: minimally invasive autopsy approach","volume":"10","author":"Castillo","year":"2015","journal-title":"PLoS 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