BibTex format
@article{Truter:2026:10.1186/s12887-026-06598-9,
author = {Truter, C and Hamilton, MS and Le, Roux C and Berndorfler, B and Buys, C and van, Niekerk M and van, Toorn R and Dunican, C and van, Rensburg I and Stanley, K and Vermeulen, S and Hesseling, AC and Doruyter, A and Warwick, J and Dupont, P and van, der Laan L and Ackermann, C and du, Preez K and Zaharie, D and Möller, M and te, Brake L and Svensson, E and Aarnoutse, R and Kaforou, M and Levin, M and Chegou, N and Solomons, R and Seddon, JA},
doi = {10.1186/s12887-026-06598-9},
journal = {BMC Pediatrics},
title = {Understanding ischemia in children with tuberculous meningitis (iThemba): a protocol paper},
url = {http://dx.doi.org/10.1186/s12887-026-06598-9},
volume = {26},
year = {2026}
}
RIS format (EndNote, RefMan)
TY - JOUR
AB - BackgroundOne million children develop tuberculosis (TB) each year and a quarter of these die. TB meningitis (TBM) is the most severe form of TB disease and even if diagnosed and treated, 20% die and over 50% of survivors are left with permanent neurological disability. Much of the morbidity and mortality associated with TBM is due to infarction yet, despite this, our understanding of the pathogenesis of infarction in TBM remains limited, especially in children. MethodsThe iThemba study (Understanding ischemia in children with tuberculous meningitis), aims to recruit 100 children with probable or confirmed TBM and obtain samples of blood and cerebrospinal fluid (CSF). All children will undergo MRI and FDG PET/CT at baseline and will have repeat MRI with further blood and CSF samples collected at 2 weeks’ follow-up. MRI will then be carried out at 24 weeks with neurodevelopmental assessment at 48 weeks. Neuroimaging will focus on methods to identify and characterize ischemic penumbra and evaluate how this correlates with clinical outcomes. RNA sequencing of blood and CSF will be used to identify differentially expressed genes and identify implicated biological pathways between children with and without infarction. Targeted proteomic profiling will be performed on plasma and CSF to determine differences in protein abundance, with a focus on proteins involved in coagulation and endothelial function. Finally, we will integrate transcriptomic, proteomic and radiomic data to generate a comprehensive understanding of the pathogenesis of infarction in children with TBM. We aim to group children into relevant biological/anatomical phenotypes, each of which may benefit from a different therapeutic approach. Using computer simulation, we will then explore the impact of potential therapeutic interventions on biological pathways for each distinct phenotype. This work may pave the way for the development of point-of-care tests at diagnosis that could allow for stratified no
AU - Truter,C
AU - Hamilton,MS
AU - Le,Roux C
AU - Berndorfler,B
AU - Buys,C
AU - van,Niekerk M
AU - van,Toorn R
AU - Dunican,C
AU - van,Rensburg I
AU - Stanley,K
AU - Vermeulen,S
AU - Hesseling,AC
AU - Doruyter,A
AU - Warwick,J
AU - Dupont,P
AU - van,der Laan L
AU - Ackermann,C
AU - du,Preez K
AU - Zaharie,D
AU - Möller,M
AU - te,Brake L
AU - Svensson,E
AU - Aarnoutse,R
AU - Kaforou,M
AU - Levin,M
AU - Chegou,N
AU - Solomons,R
AU - Seddon,JA
DO - 10.1186/s12887-026-06598-9
PY - 2026///
SN - 1471-2431
TI - Understanding ischemia in children with tuberculous meningitis (iThemba): a protocol paper
T2 - BMC Pediatrics
UR - http://dx.doi.org/10.1186/s12887-026-06598-9
VL - 26
ER -