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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
immunology and microbiology
Detection of mycobacterial lipoarabinomannan with an antigen-capture ELISA in unprocessed urine of Tanzanian patients with suspected tuberculosis
Transactions of the Royal Society of Tropical Medicine and Hygiene, Volume 99, No. 12, Year 2005
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Description
A direct antigen-capture ELISA based on the detection of mycobacterial lipoarabinomannan (LAM) in unprocessed urine was evaluated for its usefulness in clinical practice. In Tanzania, 231 patients with suspected pulmonary tuberculosis (TB) and 103 healthy volunteers were screened with standard TB tests and with the new LAM-ELISA. Of 132 patients with confirmed pulmonary mycobacterial disease (positive sputum culture), 106 were positive using the LAM-ELISA (sensitivity 80.3%). In comparison, the sensitivity of acid-fast bacilli (AFB) sputum microscopy was 62.1% (82 of 132 confirmed cases). Of the 231 patients, 17 were both culture- and AFB-negative, but had typical radiographic signs of pulmonary mycobacterial infection and did not respond to antibiotic treatment. Of these 17 patients, 13 (76.5%) had positive LAM-ELISA test results. To define the specificity of the assay, urine samples from 103 healthy volunteers were also screened using LAM-ELISA. All but one had an optical density below the cut-off (specificity 99%). Of interest was a significant correlation between level of microscopic density of mycobacteria in sputum and LAM antigen concentration in urine (χ2 = 8.44). The LAM-ELISA is a field-adapted tool that can improve screening standards in countries with a high incidence of TB. © 2005 Royal Society of Tropical Medicine and Hygiene. Published by Elsevier Ltd. All rights reserved.
Authors & Co-Authors
Boehme, Catharina C.
Germany, Munich
Ludwig-maximilians-universität München
Molokova, E.
United States, Portland
Chemogen, Inc.
Minja, Fred
Tanzania, Tanga
Tanzanian Ministry of Health
Geis, Steffen
Germany, Munich
Ludwig-maximilians-universität München
Los̈cher, Thomas
Germany, Munich
Ludwig-maximilians-universität München
Maboko, Leonard L.
Tanzania
Mbeya Medical Research Programme
Koulchin, V.
United States, Portland
Chemogen, Inc.
Höelscher, Michael
Germany, Munich
Ludwig-maximilians-universität München
Statistics
Citations: 8
Authors: 8
Affiliations: 4
Identifiers
Doi:
10.1016/j.trstmh.2005.04.014
ISSN:
00359203
Research Areas
Health System And Policy
Infectious Diseases
Study Design
Cohort Study
Study Locations
Tanzania