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  • 1.
    Balcha, Taye T.
    et al.
    Lund University, Sweden Minist Heatlh, Ethiopia .
    Winqvist, Niclas
    Lund University, Sweden Regional Department Infect Disease Control and Prevent, Sweden .
    Sturegard, Erik
    Clin Microbiol Regional and University of Labs, Sweden .
    Skogmar, Sten
    Lund University, Sweden .
    Reepalu, Anton
    Lund University, Sweden .
    Jemal, Zelalem H.
    Oromia Regional Health Bur, Ethiopia .
    Tibesso, Gudeta
    Columbia University, Ethiopia .
    Schön, Thomas
    Linköping University, Department of Clinical and Experimental Medicine, Division of Microbiology and Molecular Medicine. Linköping University, Faculty of Health Sciences. Department of Clinical Microbiology and Infectious Diseases, Kalmar County Hospital, Kalmar, Sweden.
    Bjorkman, Per
    Lund University, Sweden .
    Detection of lipoarabinomannan in urine for identification of active tuberculosis among HIV-positive adults in Ethiopian health centres2014In: Tropical medicine & international health, ISSN 1360-2276, E-ISSN 1365-3156, Vol. 19, no 6, p. 734-742Article in journal (Refereed)
    Abstract [en]

    ObjectiveTo assess the diagnostic performance of urine lipoarabinomannan (LAM) detection for TB screening in HIV-positive adults in Ethiopia. MethodsTesting for LAM was performed using the Determine TB-LAM lateral flow assay on urine samples from participants in a prospective cohort with baseline bacteriological categorisation for active TB in sputum. Characteristics of TB patients with regard to LAM status were determined. Participants were followed for 6months to evaluate survival, retention in care and incident TB. ResultsPositive LAM results were found in 78/757 participants. Among 128 subjects with definite (confirmed by culture and/or Xpert MTB/RIF) TB, 33 were LAM-positive (25.8%); the respective figure for clinically diagnosed cases was 2/20 (10%). Five of the remaining 43 LAM-positive individuals had died during the 6-month follow-up period, whereas 38 remained in care without clinical signs of TB. The overall sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were 25.8%, 92.9%, 42.3% and 86.0%, respectively. Among TB patients, LAM positivity was associated with higher WHO clinical stage, lower body mass index (BMI), CD4 cell and haemoglobin levels, and with increased mortality. A combination algorithm of urine LAM testing and sputum smear microscopy detected 49 (38.2%) of definite TB cases; among those with CD4 count 100cells/mm(3), this proportion was 66.7%. ConclusionsThe performance of urine LAM testing for TB detection was poor in this population. However, this was improved among subjects with CD4 count 100cells/mm(3). In combination with sputum microscopy urine, LAM could be considered for targeted TB screening in this subgroup.

  • 2.
    Sharp, Christopher
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Microbiology and Molecular Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Magnusson, Per
    Linköping University, Department of Clinical and Experimental Medicine, Division of Microbiology and Molecular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Chemistry.
    Davie, Michael W. J.
    Robert Jones and Agnes Hunt Orthopaed Hospital, England.
    Oginni, Lawrence M.
    Obafemi Awolowo University, Nigeria.
    Editorial Material: We are what we eat - is it time to reconsider calcium-deficiency rickets in Nigeria? (FA)2015In: Tropical medicine & international health, ISSN 1360-2276, E-ISSN 1365-3156, Vol. 20, no 4, p. 408-410Article in journal (Other academic)
    Abstract [en]

    n/a

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