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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Highly accurate diagnosis of pleural tuberculosis by immunological analysis of the pleural effusion
PLoS ONE, Volume 7, No. 1, Article e30324, Year 2012
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Description
Pleural TB is notoriously difficult to diagnose due to its paucibacillary nature yet it is the most common cause of pleural effusions in TB endemic countries such as The Gambia. We identified both cellular and soluble biomarkers in the pleural fluid that allowed highly accurate diagnosis of pleural TB compared to peripheral blood markers. Multi-plex cytokine analysis on unstimulated pleural fluid showed that IP-10 resulted in a positive likelihood ratio (LR) of 9.6 versus 2.8 for IFN-γ; a combination of IP-10, IL-6 and IL-10 resulted in an AUC of 0.96 and positive LR of 10. A striking finding was the significantly higher proportion of PPD-specific IFN-γ+TNF-α+ cell population (PPD-IGTA) in the pleural fluid compared to peripheral blood of TB subjects. Presence of this pleural PPD-IGTA population resulted in 95% correct classification of pleural TB disease with a sensitivity of 95% and specificity of 100%. These data suggest that analysis of the site of infection provides superior diagnostic accuracy compared to peripheral blood for pleural TB, likely due to the sequestration of effector cells at this acute stage of disease. © 2012 Sutherland et al.
Authors & Co-Authors
Sutherland, Jayne S.
Gambia, Banjul
Medical Research Council Laboratories Gambia
Garba, Danlani
Gambia, Banjul
Medical Research Council Laboratories Gambia
Fombah, Augustin E.
Gambia, Banjul
Medical Research Council Laboratories Gambia
Mendy-Gomez, Awa
Gambia, Banjul
Medical Research Council Laboratories Gambia
Mendy, Francis S.
Gambia, Banjul
Medical Research Council Laboratories Gambia
Antonio, Martin
Gambia, Banjul
Medical Research Council Laboratories Gambia
Townend, John A.
Gambia, Banjul
Medical Research Council Laboratories Gambia
Ideh, Readon C.
Gambia, Banjul
Medical Research Council Laboratories Gambia
Corrah, Tumani P.
Gambia, Banjul
Medical Research Council Laboratories Gambia
Ota, Martin Okechukwu C.
Gambia, Banjul
Medical Research Council Laboratories Gambia
Statistics
Citations: 45
Authors: 10
Affiliations: 1
Identifiers
Doi:
10.1371/journal.pone.0030324
e-ISSN:
19326203
Research Areas
Infectious Diseases
Study Design
Cross Sectional Study
Study Locations
Gambia