RT Journal Article
SR Electronic
T1 Performance of urine lipoarabinomannan assays for paediatric tuberculosis in Tanzania
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 761
OP 770
DO 10.1183/09031936.00003315
VO 46
IS 3
A1 Inge Kroidl
A1 Petra Clowes
A1 Klaus Reither
A1 Bariki Mtafya
A1 Gabriel Rojas-Ponce
A1 Elias N. Ntinginya
A1 Mariam Kalomo
A1 Lilian T. Minja
A1 Dickens Kowuor
A1 Elmar Saathoff
A1 Arne Kroidl
A1 Norbert Heinrich
A1 Leonard Maboko
A1 Matthew Bates
A1 Justin O'Grady
A1 Alimuddin Zumla
A1 Michael Hoelscher
A1 Andrea Rachow
YR 2015
UL http://erj.ersjournals.com/content/46/3/761.abstract
AB We evaluated the diagnostic performance of two tests based on the release of lipoarabinomannan (LAM) into the urine, the MTB-LAM-ELISA assay and the Determine TB-LAM-strip assay, in children with suspected tuberculosis (TB) in a high TB/HIV-prevalence setting.In a prospective study, 132 children with suspected active TB were assigned to diagnostic subgroups. Urine samples were subjected to testing by both assays to ascertain sensitivity and specificity. Host factors associated with positive LAM results were investigated and LAM excretion monitored after antituberculous treatment initiation.18 (13.6%) children had culture-confirmed pulmonary TB. The assays' sensitivity was higher in HIV-positive versus HIV-negative children: 70% (95% confidence interval 35–93%) versus 13% (0–53%) for MTB-LAM-ELISA and 50% (19–81%) versus 0% (0–37%) for Determine TB-LAM. In 35 (27%) children with excluded active TB, both assays showed a specificity of 97.1% (85–100%). Proteinuria and low body mass index were independently associated with LAM positivity. In most patients, LAM excretion declined to zero during or at conclusion of antituberculous treatment.HIV/TB co-infected children might benefit from LAM-based tests to aid early TB diagnosis and subsequent positive impact on morbidity and mortality. Using LAM as a rule-in and treatment-monitoring tool may also show further potential.Urine lipoarabinomannan assays show reasonable sensitivity in HIV+ but not HIV− TB-infected children http://ow.ly/N56aG