{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:37:48Z","timestamp":1791419868939,"version":"4.3.3"},"reference-count":31,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2017,7,10]],"date-time":"2017-07-10T00:00:00Z","timestamp":1499644800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["MH K23099916"],"award-info":[{"award-number":["MH K23099916"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2017,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Diagnosis of bacterial meningitis often requires cytometry, chemistry and\/or microbiologic culture capabilities. Unfortunately, laboratory resources in low\u2010resource settings (<jats:styled-content style=\"fixed-case\">LRS<\/jats:styled-content>) often lack the capacity to perform these studies. We sought to determine whether the presence of white blood cells in <jats:styled-content style=\"fixed-case\">CSF<\/jats:styled-content> detected by commercially available urine reagent strips could aid in the diagnosis of bacterial meningitis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We searched PubMed for studies published between 1980 and 2016 that investigated the use of urine reagent strips to identify cerebrospinal fluid (<jats:styled-content style=\"fixed-case\">CSF<\/jats:styled-content>) pleocytosis. We assessed studies in any language that enrolled subjects who underwent lumbar puncture and had cerebrospinal fluid testing by both standard laboratory assays and urine reagent strips. We abstracted true\u2010positive, false\u2010negative, false\u2010positive and true\u2010negative counts for each study using a diagnostic threshold of \u226510 white blood cells per microlitre for suspected bacterial meningitis and performed mixed regression modelling with random effects to estimate pooled diagnostic accuracy across studies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Our search returned 13 studies including 2235 participants. Urine reagent strips detected <jats:styled-content style=\"fixed-case\">CSF<\/jats:styled-content> pleocytosis with a pooled sensitivity of 92% (95% CI: 84\u201396), a pooled specificity of 98% (95% CI: 94\u201399) and a negative predictive value of 99% when the bacterial meningitis prevalence is 10%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Urine reagent strips could provide a rapid and accurate tool to detect <jats:styled-content style=\"fixed-case\">CSF<\/jats:styled-content> pleocytosis, which, if negative, can be used to exclude diagnosis of bacterial meningitis in settings without laboratory infrastructure. Further investigation of the diagnostic value of using protein, glucose and bacteria components of these strips is warranted.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tmi.12913","type":"journal-article","created":{"date-parts":[[2017,6,19]],"date-time":"2017-06-19T05:28:37Z","timestamp":1497850117000},"page":"1072-1080","source":"Crossref","is-referenced-by-count":14,"title":["Utility of the urine reagent strip leucocyte esterase assay for the diagnosis of meningitis in resource\u2010limited settings: meta\u2010analysis"],"prefix":"10.1111","volume":"22","author":[{"given":"William","family":"Bortcosh","sequence":"first","affiliation":[{"name":"Massachusetts General Hospital Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Siedner","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital Boston MA USA"},{"name":"Mbarara University of Science and Technology Mbarara Uganda"},{"name":"Harvard Medical School Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan W.","family":"Carroll","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital Boston MA USA"},{"name":"Mbarara University of Science and Technology Mbarara Uganda"},{"name":"Harvard Medical School Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,7,10]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)61698-6"},{"key":"e_1_2_7_3_1","unstructured":"Diarrhea management in children under five in sub\u2010Saharan Africa: does the source of care matter? \u2013 UNICEF DATA [Internet]. UNICEF DATA 2016. (Available from:http:\/\/data.unicef.org\/child-survival\/under-five.html) [12 Dec 2016]"},{"key":"e_1_2_7_4_1","unstructured":"WHO | Number of suspected meningitis cases and deaths reported [Internet]. Who.int 2016. (Available from:http:\/\/www.who.int\/gho\/epidemic_diseases\/meningitis\/suspected_cases_deaths_text\/en\/) [12 Dec 2016]"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jir707"},{"key":"e_1_2_7_6_1","unstructured":"Chapter 2: Epidemiology of Meningitis caused by Neisseria meningitidis Streptococcus pneumoniae and Haemophilus influenza. [Internet]. CDC 2016[cited 12 December 2016]. (Available from:http:\/\/www.cdc.gov\/meningitis\/lab-manual\/chpt02-epi.html) [19 July 2016]."},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1086\/425368"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.297.1.52"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2010.07.022"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1086\/499363"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.4103\/0976-3147.112729"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)64902-1"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2005.02.022"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0196-0644(89)80058-7"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.4103\/0976-3147.112737"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.4103\/0028-3886.173641"},{"key":"e_1_2_7_17_1","first-page":"362","article-title":"The leukocyte zone on Multistix\u201010\u2010SG reactive strips for cerebrospinal, seminal and peritoneal fluids","volume":"90","author":"L\u00f3pez Paredes A","year":"1988","journal-title":"Med Clin (Barc)"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(95)90931-1"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(13)70250-0"},{"key":"e_1_2_7_20_1","first-page":"135","article-title":"Correlation of leukocyte esterase detection and the presence of leukocytes in body fluids","volume":"48","author":"Smalley D","year":"1982","journal-title":"Am J Med Technol"},{"key":"e_1_2_7_21_1","first-page":"766","article-title":"Urine test strips for cerebrospinal fluid diagnosis of bacterial meningitis","volume":"91","author":"Heckmann J","year":"1996","journal-title":"Med Klin (Munich)"},{"key":"e_1_2_7_22_1","first-page":"38","article-title":"Meningitis\u2013exclusion by uric test strips","volume":"117","author":"Hastka J","year":"1992","journal-title":"Dtsch Med Wochenschr"},{"key":"e_1_2_7_23_1","first-page":"105","article-title":"Usefulness of reactive strips in the diagnosis of suppurative meningitis, at the patient's bedside","volume":"29","author":"Oses Salvador J","year":"1988","journal-title":"An Esp Pediatr"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)65304-4"},{"key":"e_1_2_7_25_1","first-page":"203","article-title":"Evaluation of leukocyte esterase reagent strips for rapid diagnosis of pyogenic meningitis","volume":"77","author":"Bisharda A","year":"2016","journal-title":"Indian Pediatr"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.2223\/JPED.207"},{"key":"e_1_2_7_27_1","first-page":"62","article-title":"Rapid diagnosis of meningitis using reagent strips","volume":"58","author":"Parmar R","year":"2004","journal-title":"Indian J Med Sci"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12098-014-1357-z"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1080\/02724936.1987.11748527"},{"key":"e_1_2_7_30_1","first-page":"63","article-title":"Urine test strips to exclude cerebral spinal fluid blood","volume":"12","author":"Marshall R","year":"2011","journal-title":"West J Emerg Med"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1177\/004947550403400417"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1177\/004947550303300114"}],"container-title":["Tropical Medicine &amp; International Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Ftmi.12913","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tmi.12913","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,1]],"date-time":"2023-10-01T21:57:09Z","timestamp":1696197429000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/tmi.12913"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,7,10]]},"references-count":31,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2017,9]]}},"alternative-id":["10.1111\/tmi.12913"],"URL":"https:\/\/doi.org\/10.1111\/tmi.12913","archive":["Portico"],"relation":{},"ISSN":["1360-2276","1365-3156"],"issn-type":[{"value":"1360-2276","type":"print"},{"value":"1365-3156","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,7,10]]}}}