Diagnostic value of two rapid immunochromatographic tests for suspected tuberculosis diagnosis in clinical practice

Objective: To evaluate and compare the diagnostic value of two immunochromatographic tests for tuberculosis (ICT-TB) in clinical practice. Material and Method: The present extended cross-sectional study investigated suspected active TB patients at Maesai district hospital, and Lampang regional hospi...

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Main Authors: Nanta S., Kantipong P., Pathipvanich P., Ruengorn C., Tawichasri C., Patumanond J.
Format: Article
Language:English
Published: 2014
Online Access:http://www.ncbi.nlm.nih.gov/pubmed/3502482
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http://cmuir.cmu.ac.th/handle/6653943832/4579
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spelling th-cmuir.6653943832-45792014-08-30T02:42:37Z Diagnostic value of two rapid immunochromatographic tests for suspected tuberculosis diagnosis in clinical practice Nanta S. Kantipong P. Pathipvanich P. Ruengorn C. Tawichasri C. Patumanond J. Objective: To evaluate and compare the diagnostic value of two immunochromatographic tests for tuberculosis (ICT-TB) in clinical practice. Material and Method: The present extended cross-sectional study investigated suspected active TB patients at Maesai district hospital, and Lampang regional hospital between April 2009 and May 2010. Subjects underwent two commercial ICT-TB serum tests including: an endogenous ICT-TB, a local made test coated with 38 kD, 16 kD, and 6 kD antigens; and an exogenous ICT-TB, an imported test coated with 38 kD and lipoarabinomanan [LAM] antigens. All subjects received two months of follow up. Results: Of 401 patients, 146 (36.4%) had active TB, and 206 (51.4%) were HIV seropositive. An endogenous ICT-TB was superior to an exogenous ICT-TB in all diagnostic values measured except for specificity. In all patients, sensitivity was low, 35.6% (95% CI: 30.9-40.3) in an endogenous ICT-TB vs. 13.7% (95% CI: 10.3-17.1) in an exogenous ICT-TB. The specificity was high and equivalent in both tests, 93.7% (95%CI: 91.4-96.1). Higher diagnostic values were found among human immunodeficiency virus (HIV) seronegatives than in HIV seropositives when unadjusted for CD4+ cell count level. The likelihood ratios (LHR) were higher in patients with CD4+ cell count over 200 cells/μL than for the HIV seronegative group (LHR+ 7.6 vs. 4.8 in an endogenous ICT-TB, and 2.5 vs. 1.9 in an exogenous ICT-TB). Conclusion: For the present study setting, an endogenous ICT-TB can be a meaningful tool for first-line testing to rule in TB suspected cases. Subgroups of HIV seronegative and HIV seropositive patients with CD4+ cell count over 200 cells/μL may be expected to benefit most from the test. 2014-08-30T02:42:37Z 2014-08-30T02:42:37Z 2011 Article 1252208 JMTHB http://www.ncbi.nlm.nih.gov/pubmed/3502482 http://www.scopus.com/inward/record.url?eid=2-s2.0-84855519706&partnerID=40&md5=18d926aae3dfd5e04f31dfe38d19bdf7 http://cmuir.cmu.ac.th/handle/6653943832/4579 English
institution Chiang Mai University
building Chiang Mai University Library
country Thailand
collection CMU Intellectual Repository
language English
description Objective: To evaluate and compare the diagnostic value of two immunochromatographic tests for tuberculosis (ICT-TB) in clinical practice. Material and Method: The present extended cross-sectional study investigated suspected active TB patients at Maesai district hospital, and Lampang regional hospital between April 2009 and May 2010. Subjects underwent two commercial ICT-TB serum tests including: an endogenous ICT-TB, a local made test coated with 38 kD, 16 kD, and 6 kD antigens; and an exogenous ICT-TB, an imported test coated with 38 kD and lipoarabinomanan [LAM] antigens. All subjects received two months of follow up. Results: Of 401 patients, 146 (36.4%) had active TB, and 206 (51.4%) were HIV seropositive. An endogenous ICT-TB was superior to an exogenous ICT-TB in all diagnostic values measured except for specificity. In all patients, sensitivity was low, 35.6% (95% CI: 30.9-40.3) in an endogenous ICT-TB vs. 13.7% (95% CI: 10.3-17.1) in an exogenous ICT-TB. The specificity was high and equivalent in both tests, 93.7% (95%CI: 91.4-96.1). Higher diagnostic values were found among human immunodeficiency virus (HIV) seronegatives than in HIV seropositives when unadjusted for CD4+ cell count level. The likelihood ratios (LHR) were higher in patients with CD4+ cell count over 200 cells/μL than for the HIV seronegative group (LHR+ 7.6 vs. 4.8 in an endogenous ICT-TB, and 2.5 vs. 1.9 in an exogenous ICT-TB). Conclusion: For the present study setting, an endogenous ICT-TB can be a meaningful tool for first-line testing to rule in TB suspected cases. Subgroups of HIV seronegative and HIV seropositive patients with CD4+ cell count over 200 cells/μL may be expected to benefit most from the test.
format Article
author Nanta S.
Kantipong P.
Pathipvanich P.
Ruengorn C.
Tawichasri C.
Patumanond J.
spellingShingle Nanta S.
Kantipong P.
Pathipvanich P.
Ruengorn C.
Tawichasri C.
Patumanond J.
Diagnostic value of two rapid immunochromatographic tests for suspected tuberculosis diagnosis in clinical practice
author_facet Nanta S.
Kantipong P.
Pathipvanich P.
Ruengorn C.
Tawichasri C.
Patumanond J.
author_sort Nanta S.
title Diagnostic value of two rapid immunochromatographic tests for suspected tuberculosis diagnosis in clinical practice
title_short Diagnostic value of two rapid immunochromatographic tests for suspected tuberculosis diagnosis in clinical practice
title_full Diagnostic value of two rapid immunochromatographic tests for suspected tuberculosis diagnosis in clinical practice
title_fullStr Diagnostic value of two rapid immunochromatographic tests for suspected tuberculosis diagnosis in clinical practice
title_full_unstemmed Diagnostic value of two rapid immunochromatographic tests for suspected tuberculosis diagnosis in clinical practice
title_sort diagnostic value of two rapid immunochromatographic tests for suspected tuberculosis diagnosis in clinical practice
publishDate 2014
url http://www.ncbi.nlm.nih.gov/pubmed/3502482
http://www.scopus.com/inward/record.url?eid=2-s2.0-84855519706&partnerID=40&md5=18d926aae3dfd5e04f31dfe38d19bdf7
http://cmuir.cmu.ac.th/handle/6653943832/4579
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