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Diagnosing Pulmonary Tuberculosis with the Xpert MTB/RIF Test

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C-reactive protein-based tuberculosis triage testing: a multi-country diagnostic accuracy study.

Brigitta Derendinger¹, Tessa K Mochizuki^2,3, Danaida Marcelo⁴

¹DSI-NRF Centre of Excellence for Biomedical Tuberculosis Research, SAMRC Centre for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.

Medrxiv : the Preprint Server for Health Sciences

|May 7, 2024

Summary

C-reactive protein (CRP) testing for tuberculosis (TB) did not meet accuracy targets in a multi-country study. Performance varied significantly by geographic region and participant subgroups, impacting its use as a reliable TB triage test.

Keywords:

C-reactive protein Tuberculosis diagnosis screening triage

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Area of Science:

Infectious Diseases
Public Health
Biomarkers

Background:

C-reactive protein (CRP) is recommended for tuberculosis (TB) screening in people with HIV (PWH).
The diagnostic accuracy of CRP for TB in people without HIV and across diverse global settings remains largely unknown.
Effective TB triage tests are crucial for timely diagnosis and management, especially in high-burden areas.

Conclusions:

CRP did not achieve the minimum accuracy targets for TB triage in this multi-country study.
Performance varied significantly by geographic location and participant subgroups, including HIV status.
Observed variations likely reflect differences in mycobacterial load and population characteristics.