Using next-generation sequencing to find infectious causes of acute encephalitis and myelitis in Guadeloupe
Acute Infectious Encephalitis and Myelitis in Guadeloupe by New Generation Sequencing Acute Infectious Encephalitis and Myelitis in Guadeloupe by New Generation Sequencing
This project will try next-generation sequencing on samples from people in Guadeloupe with acute encephalitis or myelitis to find infectious causes that routine tests miss.
Quick facts
| Study type | Observational |
|---|---|
| Enrollment | 100 (estimated) |
| Ages | 28 Days and up |
| Sex | All |
| Sponsor | Centre Hospitalier Universitaire de la Guadeloupe Academic / other |
| Locations | 1 site (Pointe-à-Pitre, Guadeloupe) |
| Trial ID | NCT07251049 on ClinicalTrials.gov |
What this trial studies
This prospective observational project will apply next-generation DNA/RNA sequencing to cerebrospinal fluid and other clinical samples from patients presenting with acute encephalitis or myelitis at the University Hospital of Guadeloupe. Patients who meet clinical inclusion criteria will have NGS performed to search for viral, bacterial, parasitic, or fungal pathogens that standard serology and PCR tests do not identify. The study builds on a four-year retrospective series that found no pathogen in 45% of cases locally and aims to produce more complete epidemiological data on infectious causes in the French West Indies. Findings are intended to improve diagnostic accuracy, guide targeted treatment, and help detect emerging or tropical-specific pathogens.
Who should consider this trial
Good fit: People aged 28 days or older who present to the University Hospital of Guadeloupe with acute onset (>24 hours) encephalitis or myelitis, meet the required major and minor clinical criteria, and have no alternative diagnosis are the intended participants.
Not a fit: Patients with chronic noninfectious neurological conditions, a clearly identified alternative cause, or who cannot provide samples at the Guadeloupe site are unlikely to benefit from this project.
Why it matters
Potential benefit: If successful, it could allow clinicians to identify previously missed infectious causes, enabling more targeted treatment and better public health tracking of emerging pathogens.
How similar studies have performed: Case reports and smaller series have used NGS to identify pathogens in previously indeterminate encephalitis or myelitis cases, but large prospective data in tropical regions remain limited.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * We selected the following eligibility criteria for patients with acute encephalitis: * Patient of at least 28 days of life * With acute onset of symptoms for more than 24 hours * A major criterion among the following: * a disorder of consciousness or alertness * memory disorder * lethargy * modification of personal or behavioral disorder, irritability * confusion, disorientation in time or space \- At least two of the following minor criteria: * temperature above 38 ° C * new onset focal neurological deficit * epileptic crisis * biological abnormality of CSF (≥ 5 Leukocytes / mm3, protein ≥ 0.40 g / L) * partial or general epileptic seizure (s) not attributable to pre-existing epileptic disease and / or a recent focal neurological symptom * brain imaging suggestive of encephalitis, with EEG abnormalities suggestive of encephalitis * And absence of alternative diagnosis (intoxication, metabolic encephalopathy) * Persons affiliated or benefiting from a social security scheme; * Having given free, informed, written and signed consent by the patient or his legal representative (no later than the day of inclusion and prior to any review required by the research); * Eligibility criteria for Acute Transverse Myelitis Patients: * Patient of at least 28 days of life * Acute onset of symptoms for more than 24 hours * Medullary focal abnormality, responsible for motor, sensory or autonomic symptoms * contrast enhancement on bone marrow MRI and / or abnormal CSF (≥ 5GB / mm3, protein uptake ≥ 0.40 g / L) * Evolution between nadir and maximum symptoms, less than 4 weeks * Persons affiliated or benefiting from a social security scheme; * Having given free, informed, written and signed consent by the patient or his legal representative (no later than the day of inclusion and prior to any review required by the research); Exclusion Criteria: * Primary vasculitis of the central nervous system or a documented specific impairment in an autoimmune condition * Cerebral thrombophlebitis if not associated with encephalitis * Meningitis without clinical or paraclinical argument for cerebral parenchymal involvement * Pyogenic abscess * Cerebral or spinal abscess * Tumoral or hematological pathology of the central nervous system * Toxic or metabolic encephalopathy * Transverse myelitis with vascular or traumatic origin * Known chronic infection with HTLV virus
Where this trial is running
Pointe-à-Pitre, Guadeloupe
- Centre Hospitalier Universitaire de la Guadeloupe — Pointe-à-Pitre, Guadeloupe, Guadeloupe (Recruiting)
Study contacts
- Principal investigator: Hugo CHAUMONT, Doctor — CHU de la Guadeloupe
- Study coordinator: Val"érie HAMONY-SOTER
- Email: valerie.soter@chu-guadeloupe.fr
- Phone: +590 590 93 46 77
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.