Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2009 Aug;13(8):989-95.

Blinded evaluation of commercial urinary lipoarabinomannan for active tuberculosis: a pilot study

P Daley  1 , J S Michael, P Hmar, A Latha, P Chordia, D Mathai, K R John, M Pai
Affiliations

Blinded evaluation of commercial urinary lipoarabinomannan for active tuberculosis: a pilot study

P Daley et al. Int J Tuberc Lung Dis. 2009 Aug.

Abstract

Setting: Urine antigen testing is an attractive strategy for the diagnosis of active tuberculosis (TB), but accuracy data are scarce.

Objective: To prospectively evaluate the diagnostic performance of commercial urinary lipoarabinomannan (LAM) antigen testing for active TB among pulmonary and extra-pulmonary TB suspects.

Design: Prospective blinded evaluation of 200 adult TB suspects at a tertiary referral hospital in India. Reference standards included culture and clinical diagnosis.

Results: Patients were 61% male (mean age 40.4 years): 8.5% were human immunodeficiency virus (HIV) infected and 47 of 200 (23.5%) were culture-positive for TB. Compared to positivity on either Löwenstein-Jensen (LJ) or BACTEC cultures, LAM sensitivity was 17.8% (95%CI 8.5-32.6), while specificity was 87.7% (95%CI 81.3-92.3). Compared to positivity on both LJ and BACTEC, LAM sensitivity was 5.8% (95%CI 12.5-44.9), with a specificity of 88.8% (95%CI 82.7-92.9). Compared to the clinical diagnosis, LAM sensitivity was 20.0% (95%CI 1.1-70.1), with a specificity of 83.3% (95%CI 50.9-97.0). HIV and smear status did not influence test accuracy.

Conclusion: In its current form, LAM is insensitive for the diagnosis of active TB, although its specificity is adequate.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Study recruitment process and final clinical diagnosis. TB = tuberculosis; ATT = anti-tuberculosis treatment.
Figure 2
Figure 2
Receiver operating characteristic (ROC) curve of LAM diagnostic performance with positivity on LJ or BACTEC as the reference standard. LAM = lipoarabinomannan; LJ = Löwenstein-Jensen.
See this image and copyright information in PMC

References

    1. Pai M, O’Brien R. New diagnostics for latent and active tuberculosis: state of the art and future prospects. Semin Respir Crit Care Med. 2008;29:560–568. - PubMed
    1. Pai M, Ramsay A, O’Brien R. Evidence-based tuberculosis diagnosis. PLoS Med. 2008;5:e156. - PMC - PubMed
    1. World Health Organization. WHO/HTM/TB/2008.393. Geneva, Switzerland: WHO; 2008. Global tuberculosis control: surveillance, planning, financing.
    1. World Health Organization. Towards a world free of tuberculosis. Geneva, Switzerland: WHO; 2006. Global Plan to Stop TB 2006–2015. Actions for life. - PubMed
    1. Burman WJ, Jones BE. Clinical and radiographic features of HIV-related tuberculosis. Semin Respir Infect. 2003;18:263–271. - PubMed

Publication types

Grants and funding