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. 2017 Jan 31;10(1):74.
doi: 10.1186/s13104-017-2404-4.

Performance of point-of-care urine test in diagnosing tuberculosis suspects with and without HIV infection in selected peripheral health settings of Addis Ababa, Ethiopia

Selam Niguse Sahle  1 , Dereje Teshome Asress  2 , Kassu Desta Tullu  3 , Atsebeha Gebrezgeaxier Weldemariam  4 , Habteyes Hailu Tola  4 , Yodit Alemayehu Awas  4 , Gebremdihin Gebremichael Hagos  4 , Muluwork Getahun Worku  4 , Desta Kassa Misgina  4
Affiliations

Performance of point-of-care urine test in diagnosing tuberculosis suspects with and without HIV infection in selected peripheral health settings of Addis Ababa, Ethiopia

Selam Niguse Sahle et al. BMC Res Notes. .

Abstract

Background: There are few rapid point-of-care tests (POCT) for tuberculosis (TB) for use in resource-constrained settings with high levels of human immunodeficiency virus (HIV). This hinders early tuberculosis (TB) treatment. This cross-sectional study evaluates the recently developed urine Determine tuberculosis lipoarabinomannan (TB LAM) antigen test. A total of 122 participants with signs and symptoms of TB, including 21 (17.1%) participants positive for HIV, were enrolled from September 2011 to March 2012 at three selected health centers in Addis Ababa, Ethiopia. Blood, sputum and urine samples were collected. Löwenstein-Jensen (LJ) solid culture was used as a gold standard to evaluate the performance of the Determine TB LAM antigen test. Data were analyzed using STATA (Statacorp LP, USA).

Results: Of the 122 participants with suspected TB, 35 (28.7%) had TB confirmed bacteriologically by LJ culture. The overall sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of Determine TB LAM (for both HIV-positive and HIV-negative participants) was 37.1% (95% CI 21.5-55.1), 97.7% (95% CI 91.9-99.7), 86.7% (95% CI 59.5-98.3) and 79.4% (95% CI 70.5-86.6), respectively. However, in participants who were co-infected with TB and HIV, sensitivity, specificity, PPV and NPV were 55.6% (95% CI 21.2-86.3), 100% (95% CI 73.5-100), 100% (95% CI 47.8-100) and 75.0% (95% CI 47.6-92.7). Moreover, the level of immunosuppression of the HIV-infected TB patients was found to have a significant association with the performance of Determine TB LAM (χ2 = 7.89, p = 0.002).

Conclusions: The Determine TB LAM test is a potential alternative in peripheral health settings for TB diagnosis in patients who are co-infected with HIV, with advanced immunosuppression.

Keywords: Lipoarabinomannan; Performance; Point-of-care.

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Figures

Fig. 1
Fig. 1
Tuberculosis diagnostic flow and diagnostic results of TB suspects
Fig. 2
Fig. 2
Sensitivity and specificity of Determine TB LAM test and smear microscopy; a among HIV co-infected individuals b among HIV negative individuals
See this image and copyright information in PMC

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