The Examination of ESAT-6, CFP-10, MPT-64 Antigens of Mycobacterium tuberculosis in Urine of Pediatric Tuberculosis Patient with Immunochromatography to Support the Diagnosis

Abstract

Tuberculosis in children is often a systemic complication because of their imperfect cellular immune system. ESAT-6, CFP-10, and MPT-64 are small molecular dominant antigens secreted by Mtb into the blood and filtered by the kidneys into urine. The high proportion of children with TB cases according to the Ministry of Health of the Republic of Indonesia in 2013 was 7.9%-12%. Diagnis is difficult to establish with sputum and blood samples. Therefore, it is necessary to support the diagnosis using urine samples with ICT rapid test. The purpose of this study was to determine the examination of Mtb ESAT-6, CFP-10, and MPT-64 antigens in the urine of pediatric TB patients with ICT to support the diagnosis. The method used was analytic observation with case control design. The results of the study showed that 32 of the urine of children with TB who were examined with ICT, 22 showed ESAT-6, CFP-10, and MPT-64 positive and 10 negative. Whereas, from 32 urine of healthy children, 25 were negative and 7 were positive. Analysis results showed 95% confidence (CI), p = 0.0002 (p <0.05), 78% specificity and 68.8% sensitivity compared to TB diagnosis from pediatricians. As a conclusion, Mtb ESAT-6, CFP-10, and MPT-64 antigens can be examined in the urine of pediatric TB patients with ICT to support the diagnosis.

The diagnostic value of urinary culture filtrate protein-10antigen in childhood tuberculosis

“…These results suggested that the urinary secretion of CFP-10 produced by M.tb was also detectable in children with active TB disease. Similar results were obtained in s study using an immunochromatography method to detect M.tb specific antigens in urinary specimens of children with active TB disease (20).…”

A Novel Urine Method for the Diagnosis of Active Tuberculosis by Immunoassay for the Detection of ESAT-6 Using Hydrogel Nanoparticles in HIV Patients

“…Molecular tests such as Xpert MTB/RIF 79%, genotype 30% are very effective, but high cost, also, are aimed more to determine drug sensitivity than diagnosis. Therefore, its implementation and use in low complexity laboratories is not very feasible [13] [14]. Radiology diagnosis is not very effective in HIV patients because they don't present the conventional radiologic patrons.…”