Lillian Tugume, MBChB, MPH, MMED
Nominated From: University of Minnesota
Research Site: Uganda-Makerere University (Infectious Diseases Institute)
Research Area: Central Nervous System Complications of AIDS
Primary Mentors: Dr. David Boulware, Dr. David Meya,
Research Project
Utility of Cerebrospinal Fluid C-Reactive Protein as a Diagnostic Biomarker for Tuberculous Meningitis
HIV associated tuberculous meningitis (TBM) is highly fatal (approximately 50% mortality), yet prompt diagnosis is challenging. Advances in diagnosis with GeneXpert /Rif Ultra (Cepheid) have led to improved case detection though negative predictive value is imperfect. Thus, a uniform case definition with laboratory and clinical parameters is the international referent standard used in TBM studies. Host biomarkers may have a role in further improving TBM diagnosis. C-reactive protein (CRP) is sensitive to changes in inflammation and has optimal negative predictive value for diagnosis of bacterial meningitis. We hypothesize that cerebrospinal fluid (CSF) CRP will be a cost-effective test for improving diagnostic yield for TBM when added into a step-wise algorithm.
Research Significance
My research will contribute to expanding the armamentarium of tuberculous meningitis diagnostics. TBM is a highly fatal complication of AIDS and also affects HIV negative individuals. Survivors are often burdened with neurologic disability especially when diagnosis is delayed. Current diagnostic tests are imperfect because they are not able to reasonably rule out TBM when the test is negative (low negative predictive value). My research findings could potentially improve the negative predictive value of current tests when cerebrospinal fluid C-reactive protein is incorporated into a stepwise diagnostic algorithm.
Publications
Mentors
