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
. 2010 Feb 26:10:41.
doi: 10.1186/1471-2334-10-41.

Rapid screening of MDR-TB using molecular Line Probe Assay is feasible in Uganda

Heidi Albert  1 , Freddie Bwanga, Sheena Mukkada, Barnabas Nyesiga, Julius Patrick Ademun, George Lukyamuzi, Melles Haile, Sven Hoffner, Moses Joloba, Richard O'Brien
Affiliations

Rapid screening of MDR-TB using molecular Line Probe Assay is feasible in Uganda

Heidi Albert et al. BMC Infect Dis. .

Abstract

Background: About 500 new smear-positive Multidrug-resistant tuberculosis (MDR-TB) cases are estimated to occur per year in Uganda. In 2008 in Kampala, MDR-TB prevalence was reported as 1.0% and 12.3% in new and previously treated TB cases respectively. Line probe assays (LPAs) have been recently approved for use in low income settings and can be used to screen smear-positive sputum specimens for resistance to rifampicin and isoniazid in 1-2 days.

Methods: We assessed the performance of a commercial line probe assay (Genotype MTBDRplus) for rapid detection of rifampicin and isoniazid resistance directly on smear-positive sputum specimens from 118 previously treated TB patients in a reference laboratory in Kampala, Uganda. Results were compared with MGIT 960 liquid culture and drug susceptibility testing (DST). LPA testing was also performed in parallel in a University laboratory to assess the reproducibility of results.

Results: Overall, 95.8% of smear-positive specimens gave interpretable results within 1-2 days using LPA. Sensitivity, specificity, positive and negative predictive values were 100.0%, 96.1%, 83.3% and 100.0% for detection of rifampicin resistance; 80.8%, 100.0%, 100.0% and 93.0% for detection of isoniazid resistance; and 92.3%, 96.2%, 80.0% and 98.7% for detection of multidrug-resistance compared with conventional results. Reproducibility of LPA results was very high with 98.1% concordance of results between the two laboratories.

Conclusions: LPA is an appropriate tool for rapid screening for MDR-TB in Uganda and has the potential to substantially reduce the turnaround time of DST results. Careful attention must be paid to training, supervision and adherence to stringent laboratory protocols to ensure high quality results during routine implementation.

PubMed Disclaimer

References

    1. World Health Organisation. Global tuberculosis control - epidemiology, strategy, financing. WHO Report 2009 WHO/HTM/TB/2009.411. http://www.who.int/tb/publications/global_report/2009/en/index.html Accessed 19 November 2009.
    1. Lukoye D, Cobelens F, Ezati N, Kirimunda S, Adatu F, Konde J, Joloba M. Anti-tuberculosis drug resistance in Kampala, Uganda, has not changed and shows no association with HIV infection. The 27th Uganda Medical Laboratory Technology Association Scientific Conference, Kabale, Uganda. 2009.
    1. World Health Organisation. Policy Statement. Molecular Line Probe Assays for Rapid Screening of patients at risk of multidrug resistant tuberculosis (MDR-TB), 2008. http://www.who.int/tb/dots/laboratory/lpa_policy.pdf Accessed 18 November 2009.
    1. Ling D, Zwerling A, Pai M. GenoType MTBDR assays for the diagnosis of multidrug-resistant tuberculosis: a meta-analysis. Eur Respir J. 2008;32:1165–1174. doi: 10.1183/09031936.00061808. - DOI - PubMed
    1. World Health Organisation. Use of Liquid TB culture and drug susceptibility testing (DST) in low- and medium- income settings. 2007. http://www.who.int/tb/dots/laboratory/policy/en/index3.html Accessed 18 November 2009.

Publication types

LinkOut - more resources