biostudies-literatureSingh BWorld Health OrganizationNational Institute for Health Research (NIHR)Wellcome Trust991-1003https://www.ebi.ac.uk/biostudies/studies/S-EPMC7618301biostudies-literatureUnknown405(10483)<h4>Background</h4>Brain infections pose substantial challenges in diagnosis and management and carry high mortality and morbidity, especially in low-income and middle-income countries. We aimed to improve the diagnosis and early management of patients admitted to hospital (adults aged 16 years and older and children aged >28 days) with suspected acute brain infections at 13 hospitals in Brazil, India, and Malawi.<h4>Methods</h4>With hospital stakeholders, policy makers, and patient and public representatives, we co-designed a multifaceted clinical and laboratory intervention, informed by an evaluation of routine practice. The intervention, tailored for each setting, included a diagnostic and management algorithm, a lumbar puncture pack, a testing panel, and staff training. We used multivaLancet (London, England)A multifaceted intervention to improve diagnosis and early management of hospitalised patients with suspected acute brain infections in Brazil, India, and Malawi: an international multicentre intervention study.PMC7618301NIHR20013400117/63/11Rupali PGanganakudige Manjappaiah MSuresh Rao ACosta Lima MMurthy KNyondo-Mipando ALRay SNetravathi MDuarte RCornick JVarkki SDDesai ASLilford RJFranca RFOBrito Ferreira MLEaston ARakesh GSilva Lira de Lucena APalanikumar PMiraclin AMwapasa VAbhilash KPPGunasekaran KNewton CRBilima SKuriakose KGowda VKCorreia RVChafunya CSolomon TSiwombo MAbraham AMDhar SCorreia JBSajiwa PFajardo Modol ATovey JMcGill FChaturvedi SLipunga GDda Silva Antonio MEPrabhu SThakur RRadhika BVRosala-Hallas AHodel EMFerreira Cronemberger LKamath PBTAdhikari DDGriffiths MJThomas NSejvar JJde Sequeira PCArumugam AVeeraraghavan BLopez EKinhal UChennupalli LVasconcelos de Lima Cavalcanti TYHolla VKamwana MDeodhar DNewbigging NPattabiraman CGhale BCValdoleiros SRSingh BPradeep BSKapachika AERodgers EKadzuwa BPrakash JJASimon AWood Gvan den Brekel NJamu FJansi Rani S LDamodar TMenyere MLahiri DMhlanga SPersis Jeyakumar HJones JARavi VChitala CMendosa JMMphombee MLenin AKumar RKumar SKang Gda Silva EMSomasundaran Ade Brito CAALobo KThangavelu PParry CMChiipanthenga EChandrashekar NSomalwar KMathew DSharma JMbale ESheha IKadewere JTurtle LMallewa MLant SHansdak SGS Nair VBrain Infections Global Intervention Study GroupDesmond NVasudev AK PMahantesh SS JGe AMaluwa CBrookes Rde Moura Brasil Matos ABasavaraja GVAswathanarayan ASekar KPhiri TJSudan MCavalcanti de Moura VRNjirammadzi JNavvuga PShabani ASr MWhittle LMunichannappa JNavya CThomas PTKalima MSreenath SNatarajan AAlex RGRawlinson RChandy GGururaj GMammen SSn VRajendran SHarrison JMwangalika GVerghese VPSmyth MPimentel Lopes de Melo CArraes LWMSFletcher GJSampreetha DDua TMichael BDBurnside GDp DAlapati SHAaron SVignesh Kumar JAnscombe CLang TSivadasan ADenis BSalley PReddy Vr SPriyalatha SKMoore SCfalseA multifaceted intervention to improve diagnosis and early management of hospitalised patients with suspected acute brain infections in Brazil, India, and Malawi: an international multicentre intervention study.<h4>Background</h4>Brain infections pose substantial challenges in diagnosis and management and carry high mortality and morbidity, especially in low-income and middle-income countries. We aimed to improve the diagnosis and early management of patients admitted to hospital (adults aged 16 years and older and children aged >28 days) with suspected acute brain infections at 13 hospitals in Brazil, India, and Malawi.<h4>Methods</h4>With hospital stakeholders, policy makers, and patient and public representatives, we co-designed a multifaceted clinical and laboratory intervention, informed by an evaluation of routine practice. The intervention, tailored for each setting, included a diagnostic and management algorithm, a lumbar puncture pack, a testing panel, and staff training. We used multiva2025-01-01T00:00:00Z2025 Mar2026-05-15T03:22:45.92Z2026-05-15T03:12:43.538ZS-EPMC76183014008140010.1016/S0140-6736(25)00263-6