![]() ![]() One LAM test $1+ grade (AUROC = 0.66 95% CI: 0.60 to 0.73) was significantly better than sputum AFB alone. A 2 LAM test strategy had a sensitivity of 43% (95% CI: 29% to 57%). Using $1+ LAM grade as positive, 1 LAM test had sensitivity of 41% and specificity of 92% (95% CI: 88% to 95%). Among 10 " faint " positive results, 2 (20%) had culture-positive TB. Fifty-two (16%) of all participants were LAM positive by either test correlation between LAM tests was high. Results: Among 320 HIV-infected adults, median CD4 was 248 cells per cubic millimeter (interquartile range, 107–379/mm 3) 54 (17%) were TB culture positive. We used area under receiver operating curves (AUROC) to compare screening strategies. Culture-confirmed pulmonary TB was the gold standard. ![]() Nurses conducted 2 rapid urine LAM tests at the point-of-care and graded positive results from low (faint) to high (5+). Participants provided sputum for acid-fast bacilli (AFB) microscopy and culture. Methods: We enrolled newly diagnosed HIV-infected adults ($18 years) at 4 clinics, excluding those on TB therapy. 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.īackground: We assessed the role of urine lipoarabinomannan (LAM) grade and a second LAM test for HIV-associated pulmonary tuberculosis (TB) screening in outpatient clinics in South Africa. 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 (χ 2 = 7.89, p = 0.002). 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. Results: Of the 122 participants with suspected TB, 35 (28.7%) had TB confirmed bacteriologically by LJ culture. Data were analyzed using STATA (Statacorp LP, USA). Löwenstein-Jensen (LJ) solid culture was used as a gold standard to evaluate the performance of the Determine TB LAM antigen test. Blood, sputum and urine samples were collected. 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. This cross-sectional study evaluates the recently developed urine Determine tuberculosis lipoarabinomannan (TB LAM) antigen test. This hinders early tuberculosis (TB) treatment. 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). ![]()
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