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Singapore Neurologic Infections Program (SNIP)

This study is currently recruiting participants. (see Contacts and Locations)
Verified October 2016 by Singapore General Hospital
Tan Tock Seng Hospital
Duke-NUS Graduate Medical School
Changi General Hospital
Khoo Teck Puat Hospital
National University Health System, Singapore
Information provided by (Responsible Party):
Singapore General Hospital Identifier:
First received: November 4, 2013
Last updated: October 19, 2016
Last verified: October 2016

Worldwide, central nervous system infections such as inflammation of brain (encephalitis), inflammation of meninges (meningitis) and sudden onset of weakness of muscles which maybe infectious in origin result in significant illness and death and healthcare costs. Vast majority of central nervous system infections remain without an identifiable cause. There is also concern about new and emerging infections.

This study thus intends to fill in the gaps in knowledge with regards to central nervous system infections in Singapore to give a thorough description of burden of causes of central nervous system infections and detection of outbreaks of new pathogens. Patients suspected of central nervous system infection will be recruited from 5 restructured Singapore hospitals and their blood and other clinical specimens will be sent for testing. Patients will also be followed up to assess long term outcomes and socio-economic costs of these infections. This will help clinicians, policymakers and public health officials in estimating financial and societal costs of CNs infections in Singapore.

Central Nervous System Infections

Study Type: Observational [Patient Registry]
Study Design: Observational Model: Cohort
Time Perspective: Prospective
Target Follow-Up Duration: 6 Months
Official Title: Singapore Neurologic Infections Program

Further study details as provided by Singapore General Hospital:

Primary Outcome Measures:
  • Incidence rate of the various infective etiologies causing CNS infections in Singapore [ Time Frame: 36 months ]
    Annual rates of the various infective causes from year 2013 to year 2016

Secondary Outcome Measures:
  • Clinical features of patients with CNS infections in Singapore [ Time Frame: Between D1(day of recruitment)-D180(last day of follow up) ]
  • Clinical characteristics of patients diagnosed with CNS infections: . [ Time Frame: Day1- Day180 ]
    gender, presenting symptoms, duration between symptoms to diagnosis etc

  • Clinical course of patients with CNS infections, [ Time Frame: Day1-Day180 ]
    development of any complications and their long term outcomes/prognosis

  • Treatment modalities of the CNS infections [ Time Frame: Day 1-Day 180 ]

Biospecimen Retention:   Samples With DNA
Blood, cerebrospinal fluid, throat/nasopharyngeal swabs, urine and rectal swabs or stool samples wil be stored for maximum 10 years.All samples will be de-identified and coded

Estimated Enrollment: 400
Study Start Date: October 2013
Estimated Study Completion Date: March 2017
Estimated Primary Completion Date: March 2017 (Final data collection date for primary outcome measure)
Detailed Description:

The study aims to:

  1. To describe the epidemiology of CNS infections in Singapore.
  2. To improve the diagnosis of aetiologies of CNS infections through a systematic clinical, laboratory and neuro-radiological evaluation and extensive diagnostic testing.
  3. To evaluate the prognosis, long-term outcomes and socio-economic costs of CNS infections.
  4. To establish an archive of biological tissues from patients with encephalitis and CNS infections that can be utilized for future testing for emerging novel pathogens or non-infectious aetiologies.

The study will recruit 400 patients over 2 years from 5 restructured hospitals in Singapore. As this is not a comparative study, sample size was not determined.

The study involves clinical and laboratory data collection. Data will also be collected on quality of life and for health economic analysis. The quality of data and its integrity will be periodically reviewed by the Principal Investigator and members of the study team. All samples stored will be de-identified and all data will be de-identified during analysis.


Ages Eligible for Study:   21 Years to 100 Years   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Sampling Method:   Non-Probability Sample
Study Population
Any patient admitted to the hospital and who meets clinical case definition will be recruited in the study.

Inclusion Criteria:

  1. Clinical suspicion for Central Nervous system (CNS) infections, OR
  2. Any two of the following,

    1. Fever or history of fever (≥ 38 °C) during the presenting illness
    2. Seizures of new onset
    3. Focal neurological deficits
    4. Cerebrospinal fluid white cell count pleocytosis (> 4 White blood cells (WBC)/uL)
    5. Abnormal neuroimaging suggestive of CNS infection.
    6. Abnormal electroencephalogram (EEG) suggestive of CNS infection
    7. Depressed or altered level of consciousness, OR
  3. No alternative aetiology for acute paralysis identified (e.g stroke, trauma, myopathy etc)

Exclusion Criteria:

  1. Patient or next of kin unwilling to give consent
  2. Patients with indwelling ventricular devices such as EVD (external ventricular drain), VP (ventriculo-peritoneal) shunts
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its identifier: NCT02017665

Singapore General Hospital Recruiting
Singapore, Singapore, 169608
Contact: Limin Wijaya, MD    +65 6321 3479   
Contact: Ei Mon Soe, Master    +65 6321 3479   
Principal Investigator: Limin Wijaya, MD         
Sponsors and Collaborators
Singapore General Hospital
Tan Tock Seng Hospital
Duke-NUS Graduate Medical School
Changi General Hospital
Khoo Teck Puat Hospital
National University Health System, Singapore
Principal Investigator: Limin Wijaya, MD SGH
  More Information

Responsible Party: Singapore General Hospital Identifier: NCT02017665     History of Changes
Other Study ID Numbers: 2013/374/E
Study First Received: November 4, 2013
Last Updated: October 19, 2016

Keywords provided by Singapore General Hospital:
viral infections
central nervous system

Additional relevant MeSH terms:
Communicable Diseases
Central Nervous System Infections
Central Nervous System Diseases
Nervous System Diseases processed this record on April 21, 2017