PMID- 31315704
OWN - NLM
STAT- MEDLINE
DCOM- 20200319
LR  - 20200319
IS  - 1815-7920 (Electronic)
IS  - 1027-3719 (Linking)
VI  - 23
IP  - 6
DP  - 2019 Jun 1
TI  - Point-of-care urine lipoarabinomannan antigen detection for diagnosis of 
      tuberculosis in children.
PG  - 714-719
LID - 10.5588/ijtld.18.0364 [doi]
AB  - <sec> <title>BACKGROUND</title> Diagnosis of tuberculosis (TB) in children 
      remains challenging due to the paucibacillary nature of the disease. Detection of 
      TB using urine lipoarabinomannan (LAM) antigen was evaluated in children with 
      presumed TB. </sec> <sec> <title>MATERIAL and METHODS</title> Children with 
      presumed intrathoracic tuberculosis (ITTB) and lymph node TB (LNTB) were 
      enrolled. Expectorated or induced sputum or gastric aspirates from ITTB patients 
      and fine-needle cytological aspirates from LNTB patients were subjected to 
      Ziehl-Neelsen staining, MGIT960 culture and Xpert((R)) MTB/RIF testing. Urine 
      samples were tested to detect LAM, and the sensitivity and specificity 
      calculated. </sec> <sec> <title>RESULTS</title> Of 280 children with presumed 
      ITTB and 101 with presumed LNTB, respectively 71 (25.3%) and 25 (24.7%) were 
      categorised as 'confirmed TB', 70 (25%) and 33 (32.7%) as 'unconfirmed TB', and 
      139 (49.6%) and 43 (42.5%) as 'unlikely TB'. Respectively 8 (2.8%) children with 
      ITTB and 3 (2.9%) with LNTB were positive on smear, 56 (20.0%) and 23 (22.7%) on 
      Xpert, and 50 (17.8%) and 9 (8.9%) on culture. LAM assay sensitivity was 73.2% in 
      confirmed ITTB cases, and 76% in confirmed LNTB cases; LAM assay specificity in 
      children with ITTB and those with LNTB initiated on anti-tuberculosis treatment 
      was respectively 92% and 93%. Detection of TB using the LAM assay was 
      significantly better than detection using Xpert (P < 0.05 vs. P < 0.002). </sec> 
      <sec> <title>CONCLUSION</title> Urinary LAM testing showed high specificity and 
      sensitivity, was detected in more cases initiated on treatment than reference 
      tests, and improved disease detection by 38.5% in ITTB patients and by 41.6% in 
      LNTB patients. </sec>.
FAU - Gautam, H
AU  - Gautam H
AD  - Department of Microbiology.
FAU - Singla, M
AU  - Singla M
AD  - Department of Paediatrics, All India Institute of Medical Sciences, New Delhi, 
      India.
FAU - Jain, R
AU  - Jain R
AD  - Department of Paediatrics, All India Institute of Medical Sciences, New Delhi, 
      India.
FAU - Lodha, R
AU  - Lodha R
AD  - Department of Paediatrics, All India Institute of Medical Sciences, New Delhi, 
      India.
FAU - Kabra, S K
AU  - Kabra SK
AD  - Department of Paediatrics, All India Institute of Medical Sciences, New Delhi, 
      India.
FAU - Singh, U B
AU  - Singh UB
AD  - Department of Microbiology.
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - France
TA  - Int J Tuberc Lung Dis
JT  - The international journal of tuberculosis and lung disease : the official journal 
      of the International Union against Tuberculosis and Lung Disease
JID - 9706389
RN  - 0 (Lipopolysaccharides)
RN  - 0 (lipoarabinomannan)
SB  - IM
MH  - Adolescent
MH  - Child
MH  - Child Health Services
MH  - Child, Preschool
MH  - Female
MH  - Humans
MH  - India
MH  - Infant
MH  - Lipopolysaccharides/*urine
MH  - Male
MH  - Molecular Diagnostic Techniques
MH  - Mycobacterium tuberculosis/immunology/isolation & purification
MH  - *Point-of-Care Systems
MH  - Sensitivity and Specificity
MH  - Tuberculosis, Pulmonary/*diagnosis/urine
MH  - Urinalysis
EDAT- 2019/07/19 06:00
MHDA- 2020/03/20 06:00
CRDT- 2019/07/19 06:00
PHST- 2019/07/19 06:00 [entrez]
PHST- 2019/07/19 06:00 [pubmed]
PHST- 2020/03/20 06:00 [medline]
AID - 10.5588/ijtld.18.0364 [doi]
PST - ppublish
SO  - Int J Tuberc Lung Dis. 2019 Jun 1;23(6):714-719. doi: 10.5588/ijtld.18.0364.