Value of ELISA Using Antigen 60 for the Diagnosis of Tuberculosis in Children

Delacourt, Christophe; Gobin, Jovana; Gaillard, J; Blic, J. de; Véron, Michel; Scheinmann, P.

doi:10.1378/chest.104.2.393

Cited by 49 publications

(34 citation statements)

References 16 publications

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“…Turneer et al did not find the anti A60 IgM and IgG measurements useful in the diagnosis of primary TB or mycobacterial adenitis in children 9 . Delacourt et al found that using the anti-A60 IgG test and a specificity of 98%, a positive serodiagnosis was observed in 68% of children with clinically active TB 10 . The IgM test, however, had a low sensitivity of 19%.…”

Section: Discussionmentioning

confidence: 99%

Sero diagnosis of tuberculosis in children using two ELISA kits

Swaminathan¹,

Umadevi

Shantha

et al. 1999

Indian J Pediatr

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Abstract. The diagnosis of childhood tuberculosis is based on circumstantial evidence in the absence of a gold standard in the majority of cases. Sero-diagnosis offers scope for an early diagnosis in a variety of clinical conditions and is simple to perform. A number of mycobacterial antigens have been used for antibody detection assays and several are available as kits in the market. This study was done to evaluate the value of antibody detection kits (ELISA) against the A60 antigen and 38kDa antigen of Mycobacterium tuberculosis in the diagnosis of childhood tuberculosis at the outpatient department of the Institute of Social Paediatrics, Government Stanley Hospital in collaboration with Tuberculosis Research Centre, Chennai. Thirty five children with pulmonary tuberculosis, 7 with TB lymphadenitis and 22 healthy controls were studied. In addition to routine investigations including gastric lavage for AFB culture, serum antibodies against the A60 and 38kDa antigens were assayed using commercially available ELISA kits. With A60, IgM serum levels were positive in 74% of pulmonary TB cases, 57% of TB lymphadenitis cases and 50% of controls. A60 IgG was positive in 17% of pulmonary TB, 86% of TB lymphadenitis and 14% of controls. The 38 kDa IgG antibody was positive in 37% of pulmonary and 86% of TB lymphadenitis cases and 27% of controls. Among 10 culture confirmed cases, A60 IgM was positive in 8, A60 IgG in 3 and 38kDa IgG in 5 patients. The sensitivity of the tests ranged between 29% and 71% and specificity between 50% and 86%. Although the numbers are small, the results suggest that serodiagnosis using the currently available antigens of M. tuberculosis is unlikely to be a confirmatory test for tuberculosis in children. (Indian J Pediatr 1999; 66 : 837-842)

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Section: Discussionmentioning

confidence: 99%

Sero diagnosis of tuberculosis in children using two ELISA kits

Swaminathan¹,

Umadevi

Shantha

et al. 1999

Indian J Pediatr

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“…I report here 7 authors who published on this subject [22][23][24][25][26][27][28]. As indicated above, some of these studies are negative, as they report poor sensitivity in primary cases.…”

Section: Flaws In the Meta-analysis Used By The Who To Decide On Bannmentioning

confidence: 99%

A Critical Appraisal of the Ban on Serological Tests for Tuberculosis Usefulness of Serological Monitoring of Tuberculosis Antibodies during the Treatment of TB Patients

Maes¹

2016

Clin Microbiol

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In 2011, the WHO banned the use of serological tests for the detection of antibodies against mycobacteria. This ban rests on a meta-analysis that observed a disparity in accuracy and specificity of results reported in various studies using this technique. All the included results were either level II observational studies or level III expert opinions. The immense majority of studies on other aspects of TB, as microscopy and vaccine efficacy, also pertain to these levels and present the same spread of results. The WHO policy statement rests on incorrect and invalid evidence. The experts analysed a pool of published studies of widely divergent quality, using different serological markers, and drew thereupon conclusions on quality of the serological test itself instead of on the quality of the studies analysed. In addition, the authors of the meta-analysis report results that are sometimes incorrect, drew conclusions on incomplete data, removed publications from their study using dubious reasons, lumped together results that should have been analysed separately and finally failed to take into consideration the value of the golden diagnostic methods used today. I intend to prove that serology is a very useful complementary tool in the diagnostic and prognostic of mycobacterial infections and that, had the WHO based their analysis on the complete information available, they would have supported the use of some serological tools for the diagnosis of TB instead of banning them.

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“…(Seth et al, 1993). Subsequently the titre of antimycobacterial antibodies increases with age (Delacourt et al, 1993). Children with primary lesions of TB or calcified lesions also present increased titres of serum antibodies.…”

Section: Diagnostic Value Of Immunological Assays In Children With Nementioning

confidence: 99%

“…In addition, the serologic results in children with pulmonary and extrapulmonary TB exhibit an extremely varied sensitivity (20.7%-85%) (Rosen, 1990, Alde et al, 1989. Results with a better sensitivity were retrieved for A60, antigen 85 complex, 30 kDa or combinations of multiple antigens (Delacourt et al, 1993, Dayal et al, 2008, Raja et al, 2001). The specificity depends on the antigen used or the type of detected antibodies (Raja, 2001, Delacourt et al, 1993.…”

Section: Diagnostic Value Of Immunological Assays In Children With Nementioning

confidence: 99%

“…Results with a better sensitivity were retrieved for A60, antigen 85 complex, 30 kDa or combinations of multiple antigens (Delacourt et al, 1993, Dayal et al, 2008, Raja et al, 2001). The specificity depends on the antigen used or the type of detected antibodies (Raja, 2001, Delacourt et al, 1993. There are also studies suggesting a correlation between the titre of antibodies and the antituberculous treatment.…”

Section: Diagnostic Value Of Immunological Assays In Children With Nementioning

confidence: 99%

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