Evidence map›Paper›PMID 32313941›Full record

ArticleTransactions of the Royal Society of Tropical Medicine and Hygiene2020

Sensitivity of the lateral flow urine lipoarabinomannan assay in ambulant adults with advanced HIV disease: data from the TB Fast Track study.

Mpho Tlali, Katherine L Fielding, Aaron S Karat, Christopher J Hoffmann, Tshifhiwa Muravha, Alison D Grant, Salome Charalambous

Open access · hybridAbstract read
In one paragraph

Article in Transactions of the Royal Society of Tropical Medicine and Hygiene, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.1field-weighted citation impact, top 54% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 2 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 5 institutions in 3 countries.

Mpho TlaliThe Aurum Institute, Johannesburg, South Africa.
Katherine L FieldingTB Centre, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
Aaron S KaratTB Centre, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
Christopher J HoffmannJohns Hopkins University School of Medicine, Baltimore, MD, USA.
Tshifhiwa MuravhaThe Aurum Institute, Johannesburg, South Africa.
Alison D GrantTB Centre, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
Salome CharalambousThe Aurum Institute, Johannesburg, South Africa.
Aurum Institute · ZAJohns Hopkins Medicine · USLondon School of Hygiene & Tropical Medicine · GBUniversity of London · GBUniversity of the Witwatersrand · ZA

Funding

Medical Research Council G1100689Medical Research Council MR/R010161/1
6 · The paper itself

Abstract

backgroundWHO guidelines recommend the lateral flow urine lipoarabinomannan assay (LF-LAM) for TB diagnosis in hospitalised HIV-positive individuals. The role of LF-LAM among ambulant patients remains less well defined. We investigated the sensitivity of LF-LAM among ambulant HIV-positive adults in primary health clinics in South Africa.

methodsWe enrolled adults (aged ≥18 y) with CD4 counts of ≤150 cells/mm3 who had not received TB treatment or antiretroviral therapy in the preceding 3 or 6 mo, respectively. Research nurses performed the LF-LAM test on freshly voided urine. Results were compared with a reference standard of positive mycobacterial culture (sputum or urine).

resultsOf 1505 (54.5% female; median age 37 y; median CD4 count 73 cells/mm3) participants, 973 (64.7%) had a mycobacterial culture result; 105/973 (10.8%) were positive for Mycobacterium tuberculosis. LF-LAM sensitivity was 41.9% (95% CI 32.3 to 51.9%) and 19.0% (95% CI 12.0 to 27.9%) using grade 1+ and grade 2+ cut-off points, respectively. Sensitivity increased with severe immunosuppression and in the presence of poor prognostic indicators (low haemoglobin, body mass index).

conclusionsWhen used as the only TB diagnostic test, LF-LAM sensitivity is suboptimal, particularly using the grade 2+ cut-off. More sensitive tests for TB are needed that can be used in primary care settings.

Indexed as

HIV InfectionsTuberculosisAdultFemaleHumansLipopolysaccharidesMaleSensitivity and SpecificitySouth AfricalipoarabinomannanLipopolysaccharidesalgorithmsHIVlipoarabinomannanSouth AfricaTBTB diagnostic tests

Identifiers

PMID32313941
PMCPMC7405171
OpenAlexW3017129900

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.