Performance of Lipoarabinomannan Assay using Cerebrospinal fluid for the diagnosis of Tuberculous meningitis among HIV patients

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dc.contributor.authorKwizera, Richard
dc.contributor.authorCresswell, Fiona V.
dc.contributor.authorMugumya, Gerald
dc.contributor.authorOkirwoth, Micheal
dc.contributor.authorKagimu, Enock
dc.contributor.authorBangdiwala, Ananta S.
dc.contributor.authorWilliams, Darlisha A.
dc.contributor.authorRhein, Joshua
dc.contributor.authorBoulware, David R.
dc.contributor.authorMeya, David B.
dc.date.accessioned2022-08-18T12:22:04Z
dc.date.available2022-08-18T12:22:04Z
dc.date.issued2019
dc.description.abstractThe diagnostic utility of the Mycobacteria tuberculosis lipoarabinomannan (TB-LAM) antigen lateral flow assay on cerebrospinal fluid (CSF) for the diagnosis of tuberculous meningitis (TBM) has not been extensively studied and the few published studies have conflicting results.Lumbar CSF from 59 HIV-positive patients with suspected TBM was tested with TB-LAM and Xpert MTB/Rif Ultra. The diagnostic performance of CSF TB-LAM was compared to positive CSF Xpert MTB/Rif Ultra (definite TBM) and a composite reference of probable or definite TBM according to the uniform case definition. Of 59 subjects, 12 (20%) had definite TBM and five (9%) had probable TBM. With reference to definite TBM, CSF TB-LAM assay had a diagnostic sensitivity of 33% and specificity of 96%. When compared to a composite reference of definite or probable TBM, the sensitivity was 24% and specificity was 95%. There were two false positive tests with TB-LAM (3+ grade). In-hospital mortality in CSF TB-LAM positive patients was 17% compared to 0% in those with definite TBM by Xpert MTB/Rif Ultra but negative LAM.Lumbar CSF TB-LAM has a poor performance in diagnosing TBM. Both urine TB-LAM and Xpert Ultra should be further investigated in the diagnosis of TBM.en_US
dc.identifier.citationKwizera, R., Cresswell, F. V., Mugumya, G., Okirwoth, M., Kagimu, E., Bangdiwala, A. S., ... & Meya, D. B. (2019). Performance of lipoarabinomannan assay using cerebrospinal fluid for the diagnosis of tuberculous meningitis among HIV patients. Wellcome open research, 4.https://doi.org/10.12688%2Fwellcomeopenres.15389.2en_US
dc.identifier.urihttps://nru.uncst.go.ug/handle/123456789/4288
dc.language.isoenen_US
dc.publisherWellcome open researchen_US
dc.subjectTuberculous meningitis, extra-pulmonary TB, lipoarabinomannan, TB-LAM, Xpert MTB/Rif Ultra, HIV, Diagnostics, cerebrospinal fluiden_US
dc.titlePerformance of Lipoarabinomannan Assay using Cerebrospinal fluid for the diagnosis of Tuberculous meningitis among HIV patientsen_US
dc.typeArticleen_US
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