ArticlePloS one2012
Test characteristics of urinary lipoarabinomannan and predictors of mortality among hospitalized HIV-infected tuberculosis suspects in Tanzania.
Article in PloS one, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 4 of them syntheses that pooled it.
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The trial behind it
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Who cites it
27 citing papers in PubMed, 4 syntheses or guidelines pooled it, 41 citations in OpenAlex.
- Factors associated with severity of pulmonary tuberculosis in people living with and without HIV: a systematic review.BMC infectious diseases · 2026Pooled it
- Diagnostic value of Lipoarabinomannan antigen for detecting Mycobacterium tuberculosis in adults and children with or without HIV infection.Journal of clinical laboratory analysis · 2022Pooled it
- Lateral flow urine lipoarabinomannan assay for detecting active tuberculosis in HIV-positive adults.The Cochrane database of systematic reviews · 2016Pooled it
- Pooled it
- Enhancing tuberculosis (TB) case detection among hospitalized patients through lay health worker led screening: a before-and-after study in KwaZulu-Natal, South Africa.Scientific reports · 2025Article
- A Breakthrough in the Challenges of Tuberculosis Diagnosis: Lateral Flow Urine Lipoarabinomannan (LAM) Assay for the Diagnosis of Active Tuberculosis in a Subset of Human Immuno Deficiency Virus (HIV) Patients at Hawassa University Comprehensive Specialized Hospital, Hawassa, Ethiopia.International medical case reports journal · 2022Article
- Tuberculosis in Hospitalized Patients With Human Immunodeficiency Virus: Clinical Characteristics, Mortality, and Implications From the Rapid Urine-based Screening for Tuberculosis to Reduce AIDS Related Mortality in Hospitalized Patients in Africa.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2020Article
- Article
- Article
- Article
- Rapid urine-based screening for tuberculosis to reduce AIDS-related mortality in hospitalized patients in Africa (the STAMP trial): study protocol for a randomised controlled trial.BMC infectious diseases · 2016Article
- Observational
- Detection of lipoarabinomannan (LAM) in urine is indicative of disseminated TB with renal involvement in patients living with HIV and advanced immunodeficiency: evidence and implications.Transactions of the Royal Society of Tropical Medicine and Hygiene · 2016Review
- Article
- Observational
- Advances in Diagnostic Assays for Tuberculosis.Cold Spring Harbor perspectives in medicine · 2015Review
- Test characteristics and potential impact of the urine LAM lateral flow assay in HIV-infected outpatients under investigation for TB and able to self-expectorate sputum for diagnostic testing.BMC infectious diseases · 2015Article
- The diagnostic targeting of a carbohydrate virulence factor from M.Tuberculosis.Scientific reports · 2015Article
- Serological diagnostic assays for HIV-associated tuberculosis in sub-Saharan Africa?Clinical and vaccine immunology : CVI · 2014Article
- Point-of-care lateral flow assays for tuberculosis and cryptococcal antigenuria predict death in HIV infected adults in Uganda.PloS one · 2014Article
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 4 countries.
Funding
Abstract
backgroundTuberculosis is the most common cause of death among patients with HIV infection living in tuberculosis endemic countries, but many cases are not diagnosed pre-mortem. We assessed the test characteristics of urinary lipoarabinomannan (LAM) and predictors of mortality among HIV-associated tuberculosis suspects in Tanzania.
methodsWe prospectively enrolled hospitalized HIV-infected patients in Dar es Salaam, with ≥2 weeks of cough or fever, or weight loss. Subjects gave 2 mLs of urine to test for LAM using a commercially available ELISA, ≥2 sputum specimens for concentrated AFB smear and solid media culture, and 40 mLs of blood for culture.
resultsAmong 212 evaluable subjects, 143 (68%) were female; mean age was 36 years; and the median CD4 count 86 cells/mm(3). 69 subjects (33%) had culture confirmation of tuberculosis and 65 (31%) were LAM positive. For 69 cases of sputum or blood culture-confirmed tuberculosis, LAM sensitivity was 65% and specificity 86% compared to 36% and 98% for sputum smear. LAM test characteristics were not different in patients with bacteremia but showed higher sensitivity and lower specificity with decreasing CD4 cell count. Two month mortality was 64 (53%) of 121 with outcomes available. In multivariate analysis there was significant association of mortality with absence of anti-retroviral therapy (p = 0.004) and a trend toward association with a positive urine LAM (p = 0.16). Among culture-negative patients mortality was 9 (75%) of 12 in LAM positive patients and 27 (38%) of 71 in LAM negative patients (p = 0.02).
conclusionsUrine LAM is more sensitive than sputum smear and has utility for the rapid diagnosis of culture-confirmed tuberculosis in this high-risk population. Mortality data raise the possibility that urine LAM may also be a marker for culture-negative tuberculosis.
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