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Table 2 Spirit figure: schedule of enrollment, interventions, and assessment

From: Intensified tuberculosis treatment to reduce the mortality of HIV-infected and uninfected patients with tuberculosis meningitis (INTENSE-TBM): study protocol for a phase III randomized controlled trial

Timepoint

Study period

 

Pre-incl T−1

Incl T0

D1

D3

D7

W2

W3

W4

W5

W6

W7

W8

W12

W28

Close-out W40

Enrolment

 Eligibility Criteria

x

              

 Informed Consent

x1

x2

             

 Randomization

 

x

             

Intervention

 Study medication

 

x

x

x

x

x

x

x

x

x

x

x

   

 Other treatments

x

x

x

x

x

x

x

x

x

x

x

x

x

x

x

 Antiviral treatment ***

(x)

(x)

(x)

(x)

(x)

(x)

(x)

x

x

x

x

x

x

x

x

Assessment

Clinical assessment

  Physical. examination*

x

x

x

x

x

x

x

x

x

x

x

x

x

x

x

  Visual tests **

 

x

x

x

x

x

x

x

x

x

x

x

x

x

x

  Neuropathy tests **

x

x

x

x

x

x

x

x

x

x

x

x

x

x

x

  Functional tests **

 

x

x

x

x

x

x

x

x

x

x

x

x

x

x

  Cognitive tests **

              

x

  Depression tests **

              

x

Imaging

  Brain imaging

(x3)

              

  Chest X-ray

x

              

Blood test

  HIV serology

x

              

  Full blood count

x

  

x

x

x

x

x

x

x

x

x

x

x*

x*

  Plasma electrolytes ††

x

  

x

x

x

x

x

x

x

x

x

x

x*

 

  Creatininemia

x

  

x

x

x

x

x

x

x

x

x

x

x*

 

  Glycemia

x

  

x

x

x

x

x

x

x

x

x

x

  

  Albuminemia

x

   

x

    

x

     

  ALT, Bilirubin (T/U)

x

  

x

x

x

x

x

x

x

x

x

x

x*

x*

  Cryptococcus Ag *

x*

              

  HIV-1 RNA Viral load *

 

x*

     

x*

   

x*

 

x*

x*

  CD4 cell count *

 

x*

     

x*

     

x*

x*

  PK rifampicin/linezolid

    

x

    

x

     

Urine tests

  Rapid Pregnancy test

x

              

  Urine LAM *

x*

              

CSF

  TBM tests

x

  

(x1)

x

  

(x2)

       

  Bacterial tests ¥

x

              

  Cryptococcus Ag *

x*

              

  PK rifampicin/linezolid

    

x

    

x

     

  Sputum TB tests

x

          

(x3)

   
  1. (x1) Signed; (x2) Orally confirmed; (x3) As clinically indicated; (x4) Only when a new CSF testing is required on the basis of the CSF results at D7; (x5) Only for patients with positive TB tests in sputum at baseline; (x6) Only when some baseline tests or sample storage could not been performed at screening; (x7) Only for HIV-positive patients
  2. D day, W week, CSF cerebrospinal fluid, ml milliliter, PK-PD pharmacokinetics-pharmacodynamics
  3. * Includes standard neurological assessment
  4. ** In patients with normal consciousness: Visual tests: Snellen, LogMAR or Tumbling E chart to evaluate visual acuity, and 14 plates Ishihara test to screen color; Other neuropathy tests: Brief Peripheral Neuropathy Score (BPNS) and Modified Total Neuropathy Score (mTNS); Functional tests: Modified Rankin Scale and WHODAS-2 questionnaire; Cognitive tests: Deterioration Cognitive Observable [DECO] test; Depression tests: PHQ-9 questionnaire.
  5. *** Antiretroviral treatment for HIV-infected: pre-treated patients continue ART at inclusion; ART-naive patients start ART 4 weeks after inclusion.
  6. Only for 40 participants
  7. †† Only in South Africa, for 160 participants