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Published on: September 14, 2011
Evaluation of TB-LAMP assay for detection of Mycobacterium tuberculosis in children
Rakesh Yadav1, Priya Daroch1, Parakriti Gupta1
1Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Insights
The TB-LAMP assay accurately detects Mycobacterium tuberculosis in children, offering a sensitive diagnostic tool for paediatric tuberculosis. This WHO-endorsed test shows performance comparable to Xpert MTB/RIF.
Area of Science:
- Medical Diagnostics
- Microbiology
- Public Health
Background:
- Paediatric tuberculosis (TB) is a significant global health challenge, particularly in developing nations.
- Diagnosing TB in children is difficult due to low bacterial loads, necessitating sensitive nucleic acid amplification tests.
Purpose of the Study:
- To evaluate the diagnostic accuracy of the World Health Organization (WHO)-endorsed TB-LAMP assay for detecting Mycobacterium tuberculosis in paediatric patients.
Main Methods:
- A prospective study involving 177 suspected paediatric TB cases.
- Parallel testing of samples using smear microscopy, mycobacterial culture, Xpert MTB/RIF, and TB-LAMP.
- Mycobacterial culture served as the reference standard for determining the diagnostic accuracy of TB-LAMP.
Main Results:
- TB-LAMP and Xpert MTB/RIF detected M. tuberculosis in 15.4% and 14.3% of samples, respectively.
- Both tests demonstrated an identical sensitivity of 84% when compared to culture.
- TB-LAMP exhibited a specificity of 96%, a positive predictive value of 77.8%, and a negative predictive value of 97.3%.
Conclusions:
- The TB-LAMP assay demonstrates diagnostic performance comparable to Xpert MTB/RIF for identifying Mycobacterium tuberculosis in paediatric samples.
- TB-LAMP is a viable and accurate tool for the microbiological diagnosis of TB in children.
Background:
Paediatric tuberculosis remains a major public health problem in developing countries. The diagnosis of tuberculosis in children is challenging because of the paucibacillary nature of the disease, due to which more sensitive nucleic acid amplification tests are needed. In this study, we determined the accuracy of WHO endorsed TB-LAMP assay for detection of Mycobacterium tuberculosis in children.
Methods:
This was a prospective study conducted between March to July, 2018. A total of 177 samples from consecutive suspected TB children were received for microbiological diagnosis of TB. All tests for Mycobacterium tuberculosis detection were performed in parallel (smear microscopy, mycobacterial culture, Xpert MTB/RIF and TB-LAMP). The diagnostic accuracy of index test i.e. TB LAMP were determined using mycobacterial culture as a reference standard.
Results:
Of the 177 samples, 2 (1.1%) were excluded from the study. Among 175 samples, TB-LAMP and Xpert MTB/RIF were positive in 27 (15.4%) and 25 (14.3%) samples, respectively. The sensitivity of both Xpert MTB/RIF and TB-LAMP was same, i.e. 84% (95%CI: 63.9-95.5%), when culture was considered as the reference standard. The specificity, positive predictive value and negative predictive value of TB-LAMP assay was 96% (95%CI: 91.5-98.5%), 77.8% (95%CI: 61.1-88.6%) and 97.3% (95%CI: 93.6-98.9%), respectively.
Conclusion:
For the detection of M. tuberculosis in paediatric samples, TB-LAMP showed a sensitivity and specificity comparable to Xpert MTB/RIF.
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