Evaluation of a commercial immunodiagnostic kit incorporating lipoarabinomannan in the serodiagnosis of pulmonary tuberculosis in Ghana.
We evaluated 'Mycodot', a commercially marketed immunodiagnostic test for tuberculosis which detects antibodies to lipoarabinomannan antigen. Serum was tested from 52 patients with newly diagnosed smear-positive pulmonary tuberculosis, of whom 20 were HIV-positive and 32 HIV-negative. Control sera were taken from 40 patients of whom 20 had acute non-tuberculous lobar pneumonia and 20 patients had no respiratory disease. The test was found to have a very high specificity of 97.5% (95% CI:92.5-100%). However, the sensitivity in HIV-negative patients was 56% (95% CI:39-73%), and was substantially lower at 25% (95% CI:6-44%) in HIV-positive patients.


CONCLUSIONS
'Mycodot' was found to be a highly specific and easily performed assay. However, the poor sensitivity, especially in HIV-infected patients, renders it unlikely to be useful either as a primary or adjunctive diagnostic test for tuberculosis, particularly in countries with a high prevalence of HIV. A larger trial of this assay in Ghana was not deemed necessary.
Lawn
S D
SD
Department of Medicine, School of Medical Sciences, University of Science and Technology, Kumasi, Ghana.
Frimpong
E H
EH
Nyarko
E
E
D000328:Adult; D000942:Antigens, Bacterial; D005869:Ghana; D006679:HIV Seropositivity / Q000150:complications; D006801:Humans; D008070:Lipopolysaccharides; D008297:Male; D009161:Mycobacterium / Q000276:immunology; D011933:Reagent Kits, Diagnostic; D012680:Sensitivity and Specificity; D014397:Tuberculosis, Pulmonary / Q000150:complications / Q000175:diagnosis*
D000942:Antigens, Bacterial; D008070:Lipopolysaccharides; D011933:Reagent Kits, Diagnostic; C050016:lipoarabinomannan