Evaluation of FASTPlaqueTB to diagnose smear-negative tuberculosis in a peripheral clinic in Kenya

Hdl Handle:
http://hdl.handle.net/10144/114139
Title:
Evaluation of FASTPlaqueTB to diagnose smear-negative tuberculosis in a peripheral clinic in Kenya
Authors:
Bonnet, M; Gagnidze, L; Varaine, F; Ramsay, A; Githui, W; Guerin, P J
Journal:
International Journal of Tuberculosis and Lung Disease
Abstract:
OBJECTIVE: To evaluate the performance and feasibility of FASTPlaqueTB in smear-negative tuberculosis (TB) suspects in a peripheral clinic after laboratory upgrading. DESIGN: Patients with cough > or=2 weeks, two sputum smear-negative results, no response to 1 week of amoxicillin and abnormal chest X-ray were defined as smear-negative suspects. One sputum sample was collected, decontaminated and divided into two: half was tested with FASTPlaqueTB in the clinic laboratory and the other half was cultured on Löwenstein-Jensen medium in the Kenyan Medical Research Institute. Test sensitivity and specificity were evaluated in all patients and in human immunodeficiency virus (HIV) infected patients. Feasibility was assessed by the contamination rate and the resources required to upgrade the laboratory. RESULTS: Of 208 patients included in the study, 56.2% were HIV-infected. Of 203 FASTPlaqueTB tests, 95 (46.8%) were contaminated, which interfered with result interpretation and led to the interruption of the study. Sensitivity and specificity were respectively 31.2% (95%CI 12.1-58.5) and 94.9% (95%CI 86.8-98.4) in all patients and 33.3% (95%CI 9.9-65.1) and 93.9% (95%CI 83.1-98.7) in HIV-infected patients. Upgrading the laboratory cost euro 20,000. CONCLUSION: FASTPlaqueTB did not perform satisfactorily in this setting. If contamination can be reduced, in addition to laboratory upgrading, its introduction in peripheral clinics would require further assessment in smear-negative and HIV co-infected patients and test adaptation for friendlier use.
Affiliation:
Epicentre, Paris, France; Liverpool School of Tropical Medicine, Liverpool, UK; United Nations Children’s Fund/United Nations Development Programme/World Bank/World Health Organization Special Programme for Research and Training for Tropical Diseases (TDR), Geneva, Switzerland; Centre for Respiratory Diseases Research, Kenya Medical Research Institute, Nairobi, Kenya
Issue Date:
1-Sep-2009
URI:
http://hdl.handle.net/10144/114139
PubMed ID:
19723400
Additional Links:
http://www.ingentaconnect.com/content/iuatld/ijtld/2009/00000013/00000009/art00011?token=00531a7707b19da97b39412f415d76763425702e4a2f2a3f422d253048296a7c2849266d656cc828e05
Submitted date:
2010-10-15
Type:
Article
Language:
en
ISSN:
1815-7920
Appears in Collections:
TB

Full metadata record

DC FieldValue Language
dc.contributor.authorBonnet, Men
dc.contributor.authorGagnidze, Len
dc.contributor.authorVaraine, Fen
dc.contributor.authorRamsay, Aen
dc.contributor.authorGithui, Wen
dc.contributor.authorGuerin, P Jen
dc.date.accessioned2010-10-29T15:11:52Z-
dc.date.available2010-10-29T15:11:52Z-
dc.date.issued2009-09-01-
dc.date.submitted2010-10-15-
dc.identifier.citationInt. J. Tuberc. Lung Dis. 2009;13(9):1112-8en
dc.identifier.issn1815-7920-
dc.identifier.pmid19723400-
dc.identifier.urihttp://hdl.handle.net/10144/114139-
dc.description.abstractOBJECTIVE: To evaluate the performance and feasibility of FASTPlaqueTB in smear-negative tuberculosis (TB) suspects in a peripheral clinic after laboratory upgrading. DESIGN: Patients with cough > or=2 weeks, two sputum smear-negative results, no response to 1 week of amoxicillin and abnormal chest X-ray were defined as smear-negative suspects. One sputum sample was collected, decontaminated and divided into two: half was tested with FASTPlaqueTB in the clinic laboratory and the other half was cultured on Löwenstein-Jensen medium in the Kenyan Medical Research Institute. Test sensitivity and specificity were evaluated in all patients and in human immunodeficiency virus (HIV) infected patients. Feasibility was assessed by the contamination rate and the resources required to upgrade the laboratory. RESULTS: Of 208 patients included in the study, 56.2% were HIV-infected. Of 203 FASTPlaqueTB tests, 95 (46.8%) were contaminated, which interfered with result interpretation and led to the interruption of the study. Sensitivity and specificity were respectively 31.2% (95%CI 12.1-58.5) and 94.9% (95%CI 86.8-98.4) in all patients and 33.3% (95%CI 9.9-65.1) and 93.9% (95%CI 83.1-98.7) in HIV-infected patients. Upgrading the laboratory cost euro 20,000. CONCLUSION: FASTPlaqueTB did not perform satisfactorily in this setting. If contamination can be reduced, in addition to laboratory upgrading, its introduction in peripheral clinics would require further assessment in smear-negative and HIV co-infected patients and test adaptation for friendlier use.en
dc.language.isoenen
dc.relation.urlhttp://www.ingentaconnect.com/content/iuatld/ijtld/2009/00000013/00000009/art00011?token=00531a7707b19da97b39412f415d76763425702e4a2f2a3f422d253048296a7c2849266d656cc828e05en
dc.rightsArchived with thanks to The International Journal of Tuberculosis and Lung Disease : the official journal of the International Union against Tuberculosis and Lung Diseaseen
dc.subject.meshAdulten
dc.subject.meshAir Microbiologyen
dc.subject.meshAmbulatory Care Facilitiesen
dc.subject.meshAmoxicillinen
dc.subject.meshAnti-Bacterial Agentsen
dc.subject.meshBacteriological Techniquesen
dc.subject.meshColony Count, Microbialen
dc.subject.meshCoughen
dc.subject.meshDeveloping Countriesen
dc.subject.meshFeasibility Studiesen
dc.subject.meshFemaleen
dc.subject.meshHIV Infectionsen
dc.subject.meshKenyaen
dc.subject.meshMaleen
dc.subject.meshMiddle Ageden
dc.subject.meshMycobacterium tuberculosisen
dc.subject.meshObserver Variationen
dc.subject.meshPredictive Value of Testsen
dc.subject.meshProspective Studiesen
dc.subject.meshReagent Kits, Diagnosticen
dc.subject.meshReproducibility of Resultsen
dc.subject.meshSensitivity and Specificityen
dc.subject.meshSpecimen Handlingen
dc.subject.meshSputumen
dc.subject.meshTuberculosis, Pulmonaryen
dc.titleEvaluation of FASTPlaqueTB to diagnose smear-negative tuberculosis in a peripheral clinic in Kenyaen
dc.typeArticleen
dc.contributor.departmentEpicentre, Paris, France; Liverpool School of Tropical Medicine, Liverpool, UK; United Nations Children’s Fund/United Nations Development Programme/World Bank/World Health Organization Special Programme for Research and Training for Tropical Diseases (TDR), Geneva, Switzerland; Centre for Respiratory Diseases Research, Kenya Medical Research Institute, Nairobi, Kenyaen
dc.identifier.journalInternational Journal of Tuberculosis and Lung Diseaseen

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