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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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 |
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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. |
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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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1681420263799914496 |