4.6 Article

The Diagnostic Accuracy of Urine Lipoarabinomannan Test for Tuberculosis Screening in a South African Correctional Facility

Journal

PLOS ONE
Volume 10, Issue 5, Pages -

Publisher

PUBLIC LIBRARY SCIENCE
DOI: 10.1371/journal.pone.0127956

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Funding

  1. Department of Health and Human Services/Centers for Disease Control and Prevention (CDC) [PS024055]
  2. National Center for HIV, Viral Hepatitis, STD, and TB Prevention (NCHHSTP) [PS024055]
  3. Global AIDS Program (GAP) [PS024055]
  4. Medical Research Council [MR/K012126/1] Funding Source: researchfish
  5. National Institute for Health Research [ACF-2012-25-011] Funding Source: researchfish

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Background We evaluated the diagnostic accuracy of the urine lipoarabinomannan (LAM) antigen detection assay (Clearview TB-ELISA) to screen for tuberculosis in a South African correctional facility. Methods Between September 2009 and October 2010, male offenders were screened for tuberculosis (symptoms, chest radiograph, two spot sputum specimens for microscopy and culture), and urine tested for LAM. Sensitivity, specificity and predictive values of LAM were calculated using definite and probable tuberculosis combined as our gold standard. Findings 33/871 (3.8%) participants (26% HIV-positive) had tuberculosis. Amongst HIV-positive vs. HIV-negative offenders the sensitivity and specificity of LAM was 7.1% vs. 0% and 98.5% vs. 99.8% respectively. Conclusion Urine LAM ELISA has inadequate sensitivity for TB screening in this population.

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