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Performance of urine lipoarabinomannan assays for paediatric tuberculosis in Tanzania

Kroidl, Inge and Clowes, Petra and Reither, Klaus and Mtafya, Bariki and Rojas-Ponce, Gabriel and Ntinginya, Elias N. and Kalomo, Mariam and Minja, Lilian T. and Kowuor, Dickens and Saathoff, Elmar and Kroidl, Arne and Heinrich, Norbert and Maboko, Leonard and Bates, Matthew and O'Grady, Justin and Zumla, Alimuddin and Hoelscher, Michael and Rachow, Andrea. (2015) Performance of urine lipoarabinomannan assays for paediatric tuberculosis in Tanzania. The European respiratory journal, 46 (3). pp. 761-770.

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Official URL: http://edoc.unibas.ch/41496/

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Abstract

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.
Faculties and Departments:09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Department of Medical Parasitology and Infection Biology > Tuberculosis Research (Gagneux)
UniBasel Contributors:Reither, Klaus
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:Munksgaard
ISSN:0903-1936
Note:Publication type according to Uni Basel Research Database: Journal article
Identification Number:
Last Modified:03 Nov 2017 07:48
Deposited On:13 Apr 2016 11:56

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