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Free Content Evaluation of the MycoDot™ test in patients with suspected tuberculosis in a field setting in Tanzania

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Abstract:

SETTING: Rapid, simple and inexpensive methods are needed to improve the diagnosis of tuberculosis in low-income countries. The MycoDot™ test has these characteristics.

OBJECTIVE: To assess the utility of the MycoDot™ test in screening patients with suspected tuberculosis.

DESIGN: Ambulatory patients presenting with symptoms of pulmonary tuberculosis were evaluated by physical examination and sputum acid-fast bacilli (AFB) microscopy. Separately, the MycoDot™ test was performed on whole blood. Patients with AFB-negative smears were treated with a 10-day course of erythromycin. Those remaining symptomatic had a chest radiograph. All sputum specimens were cultured for mycobacteria. Patients with culture-negative tuberculosis and those without a tuberculosis diagnosis were reassessed at 2 months.

RESULTS: Among the 241 patients who were evaluated, the MycoDot™ test was positive in 26% of patients with AFB-positive/culture-positive tuberculosis, 7% with AFB-negative/culture-positive tuberculosis, 7% with culture-negative tuberculosis, 19% treated for tuberculosis who did not meet study case definitions, and 16% without tuberculosis. Twenty four patients did not complete the assessment. Test sensitivity was 16%, specificity 84% and positive predictive value 45%. Sensitivity was highest (41%) in AFB-positive/HIV-negative patients and lowest (3%) in AFB-negative/HIV-positive patients.

CONCLUSION: The MycoDot™ test is not useful for the diagnosis of tuberculosis in sub-Saharan African countries, especially where HIV infection is prevalent.

Keywords: HIV; diagnosis; serology; tuberculosis

Document Type: Regular Paper

Affiliations: 1: National Institute for Medical Research, Dar Es Salaam, Tanzania 2: WHO Global Tuberculosis Programme, Geneva, Switzerland 3: National Tuberculosis and Leprosy Programme, Dar Es Salaam, Tanzania

Publication date: March 1, 1999

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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