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Evaluation of a commercial immunodiagnostic kit incorporating lipoarabinomannan in the serodiagnosis of pulmonary tuberculosis in Ghana

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We evaluated ‘Mycodot’, a commercially marketed immunodiagnostic test for tuberculosis which detects antibodies to lipoarabinomannan antigen. Serum was tested from 52 patients with newly diagnosed smear-positive pulmonary tuberculosis, of whom 20 were HIV-positive and 32 HIV-negative. Control sera were taken from 40 patients of whom 20 had acute non-tuberculous lobar pneumonia and 20 patients had no respiratory disease. The test was found to have a very high specificity of 97.5% (95%Cl:92.5–100%). However, the sensitivity in HIV-negative patients was 56% (95%Cl:39–73%), and was substantially lower at 25% (95%Cl:6–44%) in HIV-positive patients. In conclusion: ‘Mycodot’ was found to be a highly specific and easily performed assay. However, the poor sensitivity, especially in HIV- infected patients, renders it unlikely to be useful either as a primary or adjunctive diagnostic test for tuberculosis, particularly in countries with a high prevalence of HIV. A larger trial of this assay in Ghana was not deemed necessary.
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Keywords: HIV; Tuberculosis; diagnosis; lipoarabinomannan; serology

Document Type: Original Article

Affiliations: 1: Department of Medicine, School of Medical Sciences, University of Science and Technology, Kumasi, Ghana, 2: Department of Microbiology, School of Medical Sciences, University of Science and Technology, Kumasi, Ghana, 3: National Tuberculosis Control Programme, Ministy of Health, Accra, Ghana

Publication date: 1997-10-01

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