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Free Content 45/47 kilodalton (APA) antigen capture and antibody detection assays for the diagnosis of tuberculosis

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SETTING: APA complex (45/47 kDa) is an antigen specifically excreted by Mycobacterium tuberculosis and could therefore be a good candidate for diagnosis.

OBJECTIVES: To develop three APA immunocapture ELISA assays using monoclonal antibodies (Mabs) and one IgG anti-APA ELISA test, and to determine their usefulness for the diagnosis of tuberculosis in Madagascar.

DESIGN: For the Ag assays, 23 negative sputum and serum samples and 64 pairs of sputum and serum from active smear-positive patients (PTM+) were tested. For antibody assay, 116 negative controls, 143 PTM+ and 54 extra-pulmonary tuberculosis patients were tested.

RESULTS: The sensitivities of the APA antigen detection assays were low (less than 40%) for a specificity of 95.6%, using either monoclonal antibodies or clinical specimens. The anti-APA serology was more sensitive (76.9% for PTM+ patients) but less specific (73.2%). Due to their poor predictive values, these tests cannot be recommended for the routine diagnosis of tuberculosis in Madagascar.
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Keywords: APA antigen; anti-APA antibodies; immunodiagnosis; tuberculosis

Document Type: Regular Paper

Affiliations: 1: Institut Pasteur de Madagascar, Antananarivo, Madagascar 2: Institut Pasteur de Madagascar, Antananarivo, Madagascar; and Centre National Référence Mycobactéries, Ministère de la Santé, Antananarivo, Madagascar 3: Institut Pasteur, Unité Physiopathologie de l'Infection, Paris, France 4: Tuberculosis National Control Programme, Ministère de la Santé, Antananarivo, Madagascar

Publication date: 01 April 2000

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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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