Detection and Diagnostic Accuracy of Rapid Urine Lipoarabinomannan Lateral-Flow Assay in Pulmonary Tuberculosis patients in Nigeria

  • Joseph A. Anejo-Okopi Department of Microbiology, University of Jos, Jos, Nigeria
  • Okojokwu O. Julius Department of Microbiology, University of Jos, Nigeria
  • Adetunji Joshua Medicom Laboratories of Jos, Nigeria
  • Onoja Annaejane Department of Microbiology, University of Jos, Nigeria
  • Aminu Folashade Department of Microbiology, University of Jos, Nigeria
  • Ikwulono Gabriel National AIDS and STIs Control Program (NASCP) , Federal Ministry of Health, Nigeria
  • Ebonyi O. Augustine Department of Paediatrics, University of Jos, Nigeria
  • Ejeliogu Emeka Department of Paediatrics, University of Jos, Nigeria
  • Audu Onyemocho Department of Epidemiology and Community Health, College of Health Sciences, Benue State University, Nigeria

Abstract

Background: Tuberculosis (TB) is a public health challenge in both developed and developing countries. Early diagnosis is essential in preventing the further spread of the disease, but the control programs are currently facing a number of constraints and fewer than 25% of all tuberculosis cases especially childhood cases are detected. We aimed to evaluate diagnostic accuracy of a commercially available qualitative immunoassay for the detection of lipoarabinomannan (LAM) antigen of Mycobacteria in human urine by comparing its sensitivity and specificity in TB patients with the AFB and GeneXpert in individuals with presumptive tuberculosis cases.
Methods: A cross-sectional study that consecutively enrolled 53 eligible TB adults’ patients attending TB Centre, Mangu, Plateau State from February to March 2017. We applied the LAM test on urine collected as a spot and early morning sample. Diagnostic accuracy was analyzed for a microbiological TB reference standard based on Gene Xpert MTB/RIF results and for a composite reference standard including clinical data. Performance of sputum smear microscopy (AFB) was included for comparison.
Results: The mean age of the respondents was 41.0±17.0 years.) The male proportion was 36(68.0%) and female was 17(32.0%). The patients with HIV-1 Co-infection were 9(23.8%). Of the 53 patients, the positive testing rate of TB using LAM test was 11 (20.8 %). The proportion of those who tested positive using Gene Xpert was 9(17.0%) and AFB was 33(62.2%), and the sensitivity and specificity were 33.3% and 93.2%, respectively. Negative and positive predictive values were 87.23% and 50.0%, diagnostic accuracy was 83.02%.
Conclusion: The study showed great sensitivity of urine LAM test suggesting it could be useful as point of care diagnostic test for presumptive TB cases. Its high negative predictive value suggests a role in screening out uninfected patients; though GeneXpert had superior sensitivity, but the ease of the LAM test holds operational advantage as a screening method, however larger studies are needed to further determine diagnostic accuracy.

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Published
Aug 5, 2018
How to Cite
A. ANEJO-OKOPI, Joseph et al. Detection and Diagnostic Accuracy of Rapid Urine Lipoarabinomannan Lateral-Flow Assay in Pulmonary Tuberculosis patients in Nigeria. Trends Journal of Sciences Research, [S.l.], v. 3, n. 1, p. 52-59, aug. 2018. ISSN 2377-8083. Available at: <http://tjsr.org/journal/index.php/tjsr/article/view/49>. Date accessed: 16 aug. 2018.