Brain infection diagnostics in Brazil and beyond
By Dr Rafael FO Franca Brazil Principal Investigator, Brain Infections Global Intervention Study Virologist & Group Leader, Fiocruz (Oswaldo Cruz Foundation), and currently Director, Fiocruz São Paulo. To view the full paper click here (external link).
Brain infections, including encephalitis and meningitis, pose a serious health challenge, particularly for impoverished populations who are more exposed to multiple pathogens. In low- and middle-income countries (LMICs), one of the greatest barriers to effective treatment is the lack of rapid and accurate diagnostic tools, which are essential for timely and appropriate medical intervention. To address this issue, we recently conducted a multicenter study aimed at improving the diagnosis and management of brain infections. This study was carried out simultaneously in Brazil, India, and Malawi—three LMICs with distinct healthcare systems—allowing us to assess and implement solutions across different settings.
In Brazil, our focus was on strengthening diagnostic capabilities within public healthcare centers, ensuring that advanced tools and protocols were accessible to a broader patient population. This was a multidisciplinary effort, involving healthcare professionals from various fields, including clinicians, laboratory specialists, and a dedicated team of social scientists who assessed the social and systemic challenges affecting patient care. Through this integrated approach, we worked to enhance pathogen detection, expand laboratory networks, and inform public health policies to improve brain infection management.
Given that more than 80% of Brazil’s population depends on the public health system, efforts to strengthen the country’s diagnostic and treatment capacity have a significant impact. Recent viral outbreaks, particularly those caused by viruses like Zika, Chikungunya and Oropouche, have led to a substantial rise in neurological complications associated with these infections, including encephalitis and meningitis. The surge in cases highlights the urgent need for improved surveillance, rapid diagnostics, and specialized care to mitigate the burden of these diseases.
Through our project, a key achievement was the integration of molecular testing (PCR) technology for the detection of multiple pathogens. This is a powerful diagnostic tool capable of rapid and accurate pathogen detection, sometimes within hours of a patient’s admission to hospital, significantly improving early diagnosis and treatment initiation.
Beyond enhancing laboratory diagnostics, capacity building within clinical teams has been a crucial step forward. Training healthcare professionals in the choice of correct laboratory tests, interpretation and application of molecular test results ensures that advancements in diagnostics translate into more effective patient care, better treatment decisions, and improved health outcomes. By strengthening both laboratory and clinical capacities, our project was able to significantly improve both syndromic diagnosis (confirmation of a brain infection) and microbiological diagnosis (identification of the pathogen responsible), showing that a simple approach is able to contribute to the achievement of a more resilient healthcare system.
In addition to these findings, our direct collaboration with policymakers ensured that our study findings directly influenced local health strategies. It is important to mention that we have fed our tools and results into World Health Organization (WHO) projects on encephalitis and meningitis, reinforcing our study’s global impact. Moving forward, we are adapting our approach to other infectious diseases, enhancing surveillance for emerging threats and refining diagnostic workflows to strengthen Brazil’s preparedness to potential novel outbreaks. Overall, our study highlights the importance of scalable, evidence-based interventions, demonstrating how collaboration between clinicians, laboratory scientists, and policymakers can drive lasting improvements in brain infection management and broader infectious disease control efforts.