title: Lipoarabinomannan enzyme-linked immunosorbent assay for early diagnosis of childhood tuberculous meningitis.
abstract: METHODS
  Tuberculous meningitis (TBM) is a severe complication of tuberculosis (TB) predominantly affecting young children. Early initiation of treatment is important to prevent morbidity and mortality associated with TBM, emphasising the importance of early diagnosis. Among the most promising new methods for diagnosing TB are antigen-detection assays based on the detection of lipoarabinomannan (LAM).
  
  
  OBJECTIVE
  To evaluate the diagnostic value of a commercial, antigen-capture enzyme-linked immunosorbent assay (ELISA) test based on the detection of LAM in urine for the early diagnosis of TBM in children.
  
  
  METHODS
  A cross-sectional study in which urine samples from paediatric patients with suspected TBM attending the Tygerberg Children's Hospital, Cape Town, South Africa, were tested for LAM.
  
  
  RESULTS
  Complete data were available for 50 of 56 patients with suspected TBM. TBM was diagnosed in 21 (42%) patients and excluded in 29 (58%). The LAM ELISA had a sensitivity of 4.8% and a specificity of 93.1%. Serial measurements in the first 2 weeks after treatment initiation did not improve test performance.
  
  
  CONCLUSIONS
  We have shown that urinary LAM detection was of little value for the diagnosis of TBM in a cohort of paediatric patients with suspected TBM.
authors.affiliation: Department of Paediatric Infectious Diseases and Immunology, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: N
authors.initials: N
authors.lastname: Blok
authors.affiliation: Department of Paediatric Infectious Diseases and Immunology, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: D H
authors.initials: DH
authors.lastname: Visser
authors.affiliation: Department of Paediatrics and Child Health, Stellenbosch University, Cape Town, South Africa.
authors.forename: R
authors.initials: R
authors.lastname: Solomons
authors.affiliation: Department of Paediatric Infectious Diseases and Immunology, VU University Medical Center, Amsterdam, The Netherlands; Department of Paediatrics and Child Health, Stellenbosch University, Cape Town, South Africa.
authors.forename: S L
authors.initials: SL
authors.lastname: Van Elsland
authors.affiliation: KIT Biochemical Research, Royal Tropical Institute, Amsterdam, The Netherlands.
authors.forename: A L
authors.initials: AL
authors.lastname: den Hertog
authors.affiliation: Department of Paediatric Infectious Diseases and Immunology, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: A M
authors.initials: AM
authors.lastname: van Furth
mesh_terms: D000293:Adolescent; D015415:Biomarkers / Q000652:urine; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D042241:Early Diagnosis; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007223:Infant; D008070:Lipopolysaccharides / Q000652:urine*; D008297:Male; D011237:Predictive Value of Tests; D013019:South Africa; D014390:Tuberculosis, Meningeal / Q000175:diagnosis* / Q000382:microbiology / Q000652:urine
chemical_list: D015415:Biomarkers; D008070:Lipopolysaccharides; C050016:lipoarabinomannan