ArticleThe international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease2012
Diagnostic accuracy of induced sputum LAM ELISA for tuberculosis diagnosis in sputum-scarce patients.
Article in The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 25 citations in OpenAlex.
- Lateral flow urine lipoarabinomannan assay for detecting active tuberculosis in HIV-positive adults.The Cochrane database of systematic reviews · 2016Pooled it
- A controlled trial of sputum induction and routine collection methods for TB diagnosis in a South African community.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2014Trial
- Evaluation of the PATHFAST TB LAM Ag assay as a treatment monitoring tool for pulmonary tuberculosis in Nairobi, Kenya.Tropical medicine and health · 2025Article
- Article
- Monoclonal antibodies to lipoarabinomannan/arabinomannan - characteristics and implications for tuberculosis research and diagnostics.Trends in microbiology · 2023Review
- Pediatric Tuberculosis: The Impact of "Omics" on Diagnostics Development.International journal of molecular sciences · 2020Review
- Should Urine-LAM Tests Be Used in TB Symptomatic HIV-Positive Patients When No CD4 Count Is Available? A Prospective Observational Cohort Study From Malawi.Journal of acquired immune deficiency syndromes (1999) · 2020Observational
- Lateral flow urine lipoarabinomannan assay for detecting active tuberculosis in people living with HIV.The Cochrane database of systematic reviews · 2019Review
- Lipoarabinomannan in sputum to detect bacterial load and treatment response in patients with pulmonary tuberculosis: Analytic validation and evaluation in two cohorts.PLoS medicine · 2019Article
- Observational
- Biomarkers for tuberculosis: the case for lipoarabinomannan.ERJ open research · 2019Review
- Identification of potential urine proteins and microRNA biomarkers for the diagnosis of pulmonary tuberculosis patients.Emerging microbes & infections · 2018Article
- The diagnostic accuracy of pericardial and urinary lipoarabinomannan (LAM) assays in patients with suspected tuberculous pericarditis.Scientific reports · 2016Article
- Estimation of D-Arabinose by Gas Chromatography/Mass Spectrometry as Surrogate for Mycobacterial Lipoarabinomannan in Human Urine.PloS one · 2015Article
- Modeling the impact of novel diagnostic tests on pediatric and extrapulmonary tuberculosis.BMC infectious diseases · 2014Article
Corrections and comments
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Authors and funding
6 authors at 1 institution in 2 countries.
Funding
Abstract
objectiveTo examine whether a lipoarabinomannan (LAM) enzyme-linked immunosorbent assay (ELISA) that offers diagnostic utility using urine in patients with tuberculosis (TB) and human immunodeficiency virus (HIV) co-infection can be used in induced sputum to diagnose sputum-scarce patients with suspected TB.
designLAM was measured in induced sputum samples obtained from 61 consecutively recruited sputum-scarce TB suspects in a tertiary hospital respiratory clinic in South Africa. Liquid culture positivity for Mycobacterium tuberculosis was used as the reference standard. Receiver operating characteristic analysis was used to assess alternative LAM concentration cut-offs.
resultsA total of 87% (53/61) of study patients had a valid M. tuberculosis culture result; 49% (23/53) were HIV-infected and 17% (9/53) were culture-positive for M. tuberculosis. Induced sputum smear microscopy and LAM ELISA had an overall sensitivity of 56% (95%CI 27-81); however, the specificity of LAM ELISA was 48% (95%CI 34-62), while the positive and negative predictive values were respectively 18% (95%CI 8-36) and 84% (95%CI 65-94). An optimal rule-in cut-off selected by receiver operating characteristic (LAM concentration >5.73 ng/ml) increased test specificity to 98% and reduced sensitivity to 22%. Normalisation of the assay for sample total protein or cell count did not improve diagnostic accuracy.
conclusionsIn this proof-of-concept study, the ELISA was not clinically useful for TB diagnosis using induced sputum.
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