title: The diagnostic accuracy of urine lipoarabinomannan test for tuberculosis screening in a South African correctional facility.
abstract: BACKGROUND
  We evaluated the diagnostic accuracy of the urine lipoarabinomannan (LAM) antigen detection assay (Clearview TB-ELISA) to screen for tuberculosis in a South African correctional facility.
  
  
  METHODS
  Between September 2009 and October 2010, male offenders were screened for tuberculosis (symptoms, chest radiograph, two spot sputum specimens for microscopy and culture), and urine tested for LAM. Sensitivity, specificity and predictive values of LAM were calculated using definite and probable tuberculosis combined as our gold standard.
  
  
  RESULTS
  33/871 (3.8%) participants (26% HIV-positive) had tuberculosis. Amongst HIV-positive vs. HIV-negative offenders the sensitivity and specificity of LAM was 7.1% vs. 0% and 98.5% vs. 99.8% respectively.
  
  
  CONCLUSIONS
  Urine LAM ELISA has inadequate sensitivity for TB screening in this population.
authors.affiliation: Aurum Institute, Johannesburg, South Africa.
authors.forename: Yasmeen
authors.initials: Y
authors.lastname: Hanifa
authors.affiliation: Aurum Institute, Johannesburg, South Africa; CAPRISA, University of KwaZulu-Natal, Durban, South Africa.
authors.forename: Lilanganee
authors.initials: L
authors.lastname: Telisinghe
authors.affiliation: London School of Hygiene & Tropical Medicine, London, United Kingdom.
authors.forename: Katherine L
authors.initials: KL
authors.lastname: Fielding
authors.affiliation: Aurum Institute, Johannesburg, South Africa; CAPRISA, University of KwaZulu-Natal, Durban, South Africa.
authors.forename: Justin L
authors.initials: JL
authors.lastname: Malden
authors.affiliation: Aurum Institute, Johannesburg, South Africa; CAPRISA, University of KwaZulu-Natal, Durban, South Africa; London School of Hygiene & Tropical Medicine, London, United Kingdom.
authors.forename: Gavin J
authors.initials: GJ
authors.lastname: Churchyard
authors.affiliation: London School of Hygiene & Tropical Medicine, London, United Kingdom.
authors.forename: Alison D
authors.initials: AD
authors.lastname: Grant
authors.affiliation: Aurum Institute, Johannesburg, South Africa; School of Public Health, University of Witwatersrand, Johannesburg, South Africa.
authors.forename: Salome
authors.initials: S
authors.lastname: Charalambous
mesh_terms: D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology / Q000652:urine; D006801:Humans; D008070:Lipopolysaccharides / Q000652:urine*; D008297:Male; D008403:Mass Screening / Q000379:methods*; D012680:Sensitivity and Specificity; D013019:South Africa / Q000453:epidemiology; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000453:epidemiology / Q000652:urine*
chemical_list: D008070:Lipopolysaccharides; C050016:lipoarabinomannan