Diagnostic accuracy of urine based lipoarabinomannan point of care tuberculosis diagnostic test in HIV negative children: a systematic review and meta-analysis

Sood, Mangla; Sharma, S.; Sood, Sandeep; Sharma, Vipin

doi:10.1016/j.diagmicrobio.2022.115879

Cited by 4 publications

(2 citation statements)

References 17 publications

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“…Commercial urinary LAM detection technology was developed recently, including ELISA and LFA methods ( 21 ). Previous systematic studies supported the following: (1) The pooled sensitivity of urinary LAM tests varies widely between different methods or manufacturers ( 22 , 23 ); (2) Diagnostic performance is associated with HIV status and CD4+ levels ( 7 , 8 , 24 ); and (3) LAM assay may be considered an alternative biomarker for TB diagnosis ( 7 ) and serve as a “rule-in” test to screen for incident TB among patients with high risk.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic value of the cerebrospinal fluid lipoarabinomannan assay for tuberculous meningitis: a systematic review and meta-analysis

Chen,

Zhu,

Guan

et al. 2023

Front. Public Health

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ObjectiveThis systematic review aims to evaluate the diagnostic accuracy of cerebrospinal fluid (CSF) lipoarabinomannan (LAM) assays in detecting tuberculous meningitis (TBM).MethodsA systematic review search was conducted in PubMed and five other databases up to April 2023. Studies that evaluated the diagnostic accuracy of CSF LAM assays were included with either definitive or composite reference standard used as the preferred reference standard. The quality of the included studies was assessed using the QUADAS-2 tool. We performed a bivariate random-effects meta-analysis and calculated the summary diagnostic statistics.ResultsA total of six studies, including a sample size of 999, were included in the final analysis. The pooled sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) of CSF LAM for diagnosing TBM were determined to be 0.44 (95% CI: 0.31–0.58), 0.89 (95% CI: 0.81–0.93), and 0.76 (95% CI: 0.73–0.80), respectively. Significant heterogeneity was observed in both sensitivity (Q = 73.82, p < 0.01; I2 = 86.45, 95%CI: 79.64–93.27) and specificity (Q = 95.34, p < 0.01; I2 = 89.51, 95% CI: 84.61–94.42). Regression analysis indicated that the study design (retrospective vs. prospective) was associated with the heterogeneity of pooled sensitivity and specificity (all p < 0.05).ConclusionAlthough more prospective studies are required to validate the role of the CSF LAM assay, current evidence supports that the performance of the CSF LAM assay is unsatisfactory for the TBM diagnosis. Additionally, the optimization of the CSF LAM assay (e.g., improvements in CSF collection and preparation methods) should be considered to improve its performance.

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Section: Discussionmentioning

confidence: 99%

Diagnostic value of the cerebrospinal fluid lipoarabinomannan assay for tuberculous meningitis: a systematic review and meta-analysis

Chen,

Zhu,

Guan

et al. 2023

Front. Public Health

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“…As an alternative, a smear microscopy (SMEAR) test can provide a result in a few hours but with a sensitivity lower than 65% [4]. Due to its moderate cost, SMEAR is the current standard point-of-care (POC) test in low-and middle-income countries [5,6].…”

Section: Introductionmentioning

confidence: 99%

On-Field Test of Tuberculosis Diagnosis through Exhaled Breath Analysis with a Gas Sensor Array

Ketchanji Mougang,

Endale Mangamba,

Capuano

et al. 2023

Biosensors

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Tuberculosis (TB) is among the more frequent causes of death in many countries. For pulmonary TB, early diagnosis greatly increases the efficiency of therapies. Although highly sensitive tests based on nucleic acid amplification tests (NAATs) and loop-mediated isothermal amplification (TB-LAMP) are available, smear microscopy is still the most widespread diagnostics method in most low–middle-income countries, and the true positive rate of smear microscopy is lower than 65%. Thus, there is a need to increase the performance of low-cost diagnosis. For many years, the use of sensors to analyze the exhaled volatile organic compounds (VOCs) has been proposed as a promising alternative for the diagnosis of several diseases, including tuberculosis. In this paper, the diagnostic properties of an electronic nose (EN) based on sensor technology previously used to identify tuberculosis have been tested on-field in a Cameroon hospital. The EN analyzed the breath of a cohort of subjects including pulmonary TB patients (46), healthy controls (38), and TB suspects (16). Machine learning analysis of the sensor array data allows for the identification of the pulmonary TB group with respect to healthy controls with 88% accuracy, 90.8% sensitivity, 85.7% specificity, and 0.88 AUC. The model trained with TB and healthy controls maintains its performance when it is applied to symptomatic TB suspects with a negative TB-LAMP. These results encourage the investigation of electronic noses as an effective diagnostic method for future inclusion in clinical practice.

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Update on the diagnosis of tuberculosis

Kontsevaya¹,

Cabibbe²,

Cirillo³

et al. 2024

Clinical Microbiology and Infection

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Diagnostic accuracy of urine based lipoarabinomannan point of care tuberculosis diagnostic test in HIV negative children: a systematic review and meta-analysis

Cited by 4 publications

References 17 publications

Diagnostic value of the cerebrospinal fluid lipoarabinomannan assay for tuberculous meningitis: a systematic review and meta-analysis

Diagnostic value of the cerebrospinal fluid lipoarabinomannan assay for tuberculous meningitis: a systematic review and meta-analysis

On-Field Test of Tuberculosis Diagnosis through Exhaled Breath Analysis with a Gas Sensor Array

Update on the diagnosis of tuberculosis

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