C-Reactive Protein Testing for Active Tuberculosis among Inpatients without HIV in Uganda: a Diagnostic Accuracy Study

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dc.contributor.authorMeyer, Amanda J.
dc.contributor.authorOchom, Emmanuel
dc.contributor.authorTurimumahoro, Patricia
dc.contributor.authorByanyima, Patrick
dc.contributor.authorSanyu, Ingvar
dc.contributor.authorLalitha, Rejani
dc.contributor.authorKaswabuli, Sylvia
dc.contributor.authorAndama, Alfred
dc.contributor.authorWalter, Nicholas D.
dc.contributor.authorKatamba, Achilles
dc.contributor.authorCattamanchi, Adithya
dc.contributor.authorWorodria, William
dc.contributor.authorHuang, Laurence
dc.contributor.authorYoon, Christina
dc.contributor.authorDavis, Lucian
dc.date.accessioned2023-01-17T20:10:21Z
dc.date.available2023-01-17T20:10:21Z
dc.date.issued2020
dc.description.abstractThe objective of this prospective cross-sectional study, conducted at a national referral hospital in Kampala, Uganda, was to determine diagnostic performance of serum C-reactive protein (CRP) as a triage test for tuberculosis (TB) among HIV-seronegative inpatients. We calculated the sensitivity, specificity, positive and negative likelihood ratios, and positive and negative predictive values to determine the diagnostic performance of a CRP enzyme-linked immunosorbent assay (ELISA) (Eurolyser) in comparison to that of a reference standard of Mycobacterium tuberculosis culture on two sputum samples. We constructed receiver operating curves and reported performance in reference to the manufacturer’s cutoff and also to a threshold chosen to achieve sensitivity of 90%, in accordance with the WHO’s targetproduct profile for a triage test. Among 119 HIV-seronegative inpatients, 46 (39%) had culture-positive pulmonary TB. In reference to M. tuberculosis culture, CRP had a sensitivity of 78% (95% confidence interval [CI], 64 to 89%) and a specificity of 52% (95% CI, 40 to 64%) at the manufacturer’s threshold of 10 mg/liter. At a threshold of 1.5 mg/liter, the sensitivity was 91% (95% CI, 79 to 98%) but the specificity was only 21% (95% CI, 12 to 32%). Performance did not differ when stratified by illness severity at either threshold. In conclusion, among HIV-seronegative inpatients, CRP testing performed substantially below targets for a TB triage test. Additional studies among HIV-seronegative individuals in clinics and community settings are needed to assess the utility of CRP for TB screening.en_US
dc.identifier.citationMeyer AJ, Ochom E, Turimumahoro P, Byanyima P, Sanyu I, Lalitha R, Kaswabuli S, Andama A, Walter ND, Katamba A, Cattamanchi A, Worodria W, Huang L, Yoon C, Davis JL. 2021. C-reactive protein testing for active tuberculosis among inpatients without HIV in Uganda: a diagnostic accuracy study. J Clin Microbiol 59:e02162-20. https://doi.org/10 .1128/JCM.02162-20.en_US
dc.identifier.urihttps://doi.org/10 .1128/JCM.02162-20.
dc.identifier.urihttps://nru.uncst.go.ug/handle/123456789/7002
dc.language.isoenen_US
dc.publisherJournal of Clinical Microbiologyen_US
dc.subjectCRPen_US
dc.subjectAfricaen_US
dc.subjectDiagnosisen_US
dc.titleC-Reactive Protein Testing for Active Tuberculosis among Inpatients without HIV in Uganda: a Diagnostic Accuracy Studyen_US
dc.typeArticleen_US
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