The Sensitivity and Specificity of Loop-Mediated Isothermal Amplification (LAMP) Assay for Tuberculosis Diagnosis in Adults with Chronic Cough in Malawi
Autor: | Clare Flach, Chisomo L. Msefula, Marriott Nliwasa, Kruger Kaswaswa, Mercy Kamdolozi, Mphatso Mwapasa, Peter MacPherson, Hojoon Sohn, McEwen Khundi, Elizabeth L. Corbett, Palesa Chisala |
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Rok vydání: | 2016 |
Předmět: |
Male
Bacterial Diseases RNA viruses 0301 basic medicine Malawi Physiology Human immunodeficiency virus (HIV) lcsh:Medicine wc_503 HIV Infections Pathology and Laboratory Medicine medicine.disease_cause Gastroenterology Fluorescence Microscopy 0302 clinical medicine Immunodeficiency Viruses Medicine and Health Sciences Public and Occupational Health 030212 general & internal medicine lcsh:Science Microscopy Multidisciplinary biology Light Microscopy HIV diagnosis and management Middle Aged Vaccination and Immunization Body Fluids 3. Good health Actinobacteria Chronic cough Infectious Diseases Medical Microbiology Viral Pathogens Viruses Tuberculosis Diagnosis and Management Female wf_200 wb_141 Pathogens Anatomy medicine.symptom Nucleic Acid Amplification Techniques Research Article Adult medicine.medical_specialty Tuberculosis Adolescent Immunology wc_503_5 Loop-mediated isothermal amplification Antiretroviral Therapy wa_395 Research and Analysis Methods Sensitivity and Specificity Microbiology Mycobacterium tuberculosis Young Adult 03 medical and health sciences Antiviral Therapy Tuberculosis diagnosis Diagnostic Medicine Internal medicine Retroviruses medicine Humans Microbial Pathogens Bacteria business.industry lcsh:R Lentivirus Organisms Sputum Biology and Life Sciences HIV Nucleic acid amplification technique Tropical Diseases biology.organism_classification medicine.disease Mucus 030104 developmental biology Cough Chronic Disease wf_220 lcsh:Q Reagent Kits Diagnostic Preventive Medicine business Mycobacterium Tuberculosis |
Zdroj: | PLoS ONE Nliwasa, M, MacPherson, P, Chisala, P, Kamdolozi, M, Khundi, M, Kaswaswa, K, Mwapasa, M, Msefula, C, Sohn, H, Flach, C & Corbett, E L 2016, ' The Sensitivity and Specificity of Loop-Mediated Isothermal Amplification (LAMP) Assay for Tuberculosis Diagnosis in Adults with Chronic Cough in Malawi ', PLoS ONE, vol. 11, no. 5, pp. e0155101 . https://doi.org/10.1371/journal.pone.0155101 PLoS ONE, Vol 11, Iss 5, p e0155101 (2016) PLOS ONE |
ISSN: | 1932-6203 |
Popis: | Background\ud Current tuberculosis diagnostics lack sensitivity, and are expensive. Highly accurate, rapid and cheaper diagnostic tests are required for point of care use in low resource settings with high HIV prevalence.\ud \ud Objective\ud To investigate the sensitivity and specificity, and cost of loop-mediated isothermal amplification (LAMP) assay for tuberculosis diagnosis in adults with chronic cough compared to Xpert® MTB/RIF, fluorescence smear microscopy.\ud \ud Methods\ud Between October 2013 and March 2014, consecutive adults at a primary care clinic were screened for cough, offered HIV testing and assessed for tuberculosis using LAMP, Xpert® MTB/RIF and fluorescence smear microscopy. Sensitivity and specificity (with culture as reference standard), and costs were estimated.\ud \ud Results\ud Of 273 adults recruited, 44.3% (121/273) were HIV-positive and 19.4% (53/273) had bacteriogically confirmed tuberculosis. The sensitivity of LAMP compared to culture was 65.0% (95% CI: 48.3% to 79.4%) with 100% (95% CI: 98.0% to 100%) specificity. The sensitivity of Xpert® MTB/RIF (77.5%, 95% CI: 61.5% to 89.2%) was similar to that of LAMP, p = 0.132. The sensitivity of concentrated fluorescence smear microscopy with routine double reading (87.5%, 95% CI: 73.2% to 95.8%) was higher than that of LAMP, p = 0.020. All three tests had high specificity. The lowest cost per test of LAMP was at batch size of 14 samples (US$ 9.98); this was lower than Xpert® MTB/RIF (US$ 13.38) but higher than fluorescence smear microscopy (US$ 0.65).\ud \ud Conclusion\ud The sensitivity of LAMP was similar to Xpert® MTB/RIF but lower than fluorescence smear microscopy; all three tests had high specificity. These findings support the Malawi policy that recommends a combination of fluorescence smear microscopy and Xpert® MTB/RIF prioritised for people living with HIV, already found to be smear-negative, or being considered for retreatment of tuberculosis. |
Databáze: | OpenAIRE |
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