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Free Content Breath analysis as a potential diagnostic tool for tuberculosis

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SETTING: Cape Town, South Africa.

OBJECTIVES: We investigated the potential of breath analysis by gas chromatography-mass spectrometry (GC-MS) to discriminate between samples collected prospectively from patients with suspected tuberculosis (TB).

DESIGN: Samples were obtained in a TB-endemic setting in South Africa, where 28% of culture-proven TB patients had Ziehl-Neelsen (ZN) negative sputum smear. A training set of breath samples from 50 sputum culture-proven TB patients and 50 culture-negative non-TB patients was analysed using GC-MS. We used support vector machine analysis for classification of the patient samples into TB and non-TB.

RESULTS: A classification model with seven compounds had a sensitivity of 72%, a specificity of 86% and an accuracy of 79% compared with culture. The classification model was validated with breath samples from a different set of 21 TB and 50 non-TB patients from the same area, giving a sensitivity of 62%, a specificity of 84% and an accuracy of 77%.

CONCLUSION: This study shows that GC-MS breath analysis is able to differentiate between TB and non-TB breath samples even among patients with a negative ZN sputum smear but a positive culture for Mycobacterium tuberculosis. We conclude that breath analysis by GC-MS merits further research.
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Keywords: gas chromatography-mass spectrometry; statistical analysis; training set; validation set; volatile organic compounds

Document Type: Research Article

Affiliations: 1: KIT Biomedical Research, Royal Tropical Institute, Amsterdam, The Netherlands; and Analytical Chemistry and Forensic Science, Van 't Hoff Institute for Molecular Sciences, University of Amsterdam, Amsterdam, The Netherlands 2: Department of Toxicology, Research Institute NUTRIM, Maastricht University, Maastricht, The Netherlands 3: Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Stellenbosch University, Tygerberg, Cape Town, South Africa 4: KIT Biomedical Research, Royal Tropical Institute, Amsterdam, The Netherlands; Analytical Chemistry and Forensic Science, Van 't Hoff Institute for Molecular Sciences, University of Amsterdam, Amsterdam, The Netherlands

Publication date: 2012-06-01

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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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