Detecting Mycobacterium tuberculosis using the loop-mediated isothermal amplification test in South Africa
| Autor: | Gita Ramjee, Shabashini Reddy, B Spooner, S Ntoyanto, Kogieleum Naidoo, Anna Coutsoudis, Noluthando Ngomane, Koleka Mlisana, Sharana Mahomed, Tarylee Reddy, M Dlamini, Y Sakadavan, Photini Kiepiela |
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| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
Pulmonary and Respiratory Medicine medicine.medical_specialty Tuberculosis biology business.industry 030106 microbiology Significant difference Loop-mediated isothermal amplification Gold standard (test) biology.organism_classification medicine.disease Mycobacterium tuberculosis 03 medical and health sciences 0302 clinical medicine Infectious Diseases Predictive value of tests Internal medicine Coinfection Medicine Sputum 030212 general & internal medicine medicine.symptom business |
| Zdroj: | The International Journal of Tuberculosis and Lung Disease. 21:1154-1160 |
| ISSN: | 1027-3719 |
| DOI: | 10.5588/ijtld.16.0863 |
| Popis: | SETTING In South Africa, KwaZulu-Natal is the epicentre of the human immunodeficiency virus (HIV) epidemic, where approximately 70% of people with tuberculosis (TB) are co-infected with HIV. Undiagnosed TB contributes to high mortality in HIV-infected patients. Delays in diagnosing TB and treatment initiation result in prolonged transmission and increased infectiousness. OBJECTIVE To evaluate the LoopampTM MTBC Detection kit (TB-LAMP; based on the loop-mediated isothermal amplification assay), smear microscopy and Xpert test with the gold standard of mycobacterial culture. METHODS Sputum samples were collected from 705 patients with symptoms of pulmonary TB attending a primary health care clinic. RESULTS The TB-LAMP assay had significantly higher sensitivity than smear microscopy (72.6% vs. 45.4%, P < 0.001), whereas specificity was slightly lower (99% vs. 96.8%, P = 0.05), but significantly higher than Xpert (92.9%, P = 0.004). There was no significant difference in sensitivity of smear-positive, culture-positive and smear-negative, culture-positive sputum samples using TB-LAMP vs. Xpert (respectively 95.9%/55.9% vs. 97.6%/66.1%; P =0.65, P = 0.27). The positive predictive value of TB-LAMP was significantly higher than that of Xpert (87.5% vs. 77.0%; P = 0.02), but similar to that of smear microscopy (94.2%; P = 0.18). The negative predictive value was respectively 91.9%, 92.5% (P = 0.73) and 83.1% (P = 0.0001). CONCLUSION Given its ease of operability, the TB-LAMP assay could be implemented as a point-of-care test in primary health care settings, and contribute to reducing treatment waiting times and TB prevalence. |
| Databáze: | OpenAIRE |
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