title: Evaluation of urine pneumococcal antigen test performance among adults in Western Kenya.
abstract: When used in an area of rural western Kenya, the BinaxNOW® urine antigen test had a sensitivity of 67% (95% Confidence Interval [CI]: 43-85%) among 21 adults ≥15 years old with acute respiratory illnesses and pneumococcal bacteremia and a specificity of 98% (95% CI: 96-99%) among 660 adults ≥15 years old without fever or cough. The specificity of the test was not significantly affected by pneumococcal colonization, regardless of patients' HIV status, age, or sex. Use of the pneumococcal urine antigen test in clinical assessments of adults in Africa with acute respiratory illness is a viable option regardless of whether a patient is colonized by pneumococci, even among HIV-infected adults, although the moderate sensitivity of the urine antigen test indicates that the test is probably best used clinically as part of a panel with other tests that can detect pneumococci.
authors.affiliation: Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, GA; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA. Electronic address: lhampton@cdc.gov.
authors.forename: Lee M
authors.initials: LM
authors.lastname: Hampton
authors.affiliation: Kenya Medical Research Institute/Centers for Disease Control and Prevention, Kisumu, Kenya.
authors.forename: Godfrey
authors.initials: G
authors.lastname: Bigogo
authors.affiliation: Kenya Medical Research Institute/Centers for Disease Control and Prevention, Kisumu, Kenya.
authors.forename: Geofrey
authors.initials: G
authors.lastname: Jagero
authors.affiliation: Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, GA.
authors.forename: Maria
authors.initials: M
authors.lastname: da Gloria Carvalho
authors.affiliation: Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, GA.
authors.forename: Fabiana
authors.initials: F
authors.lastname: Pimenta
authors.affiliation: Kenya Medical Research Institute/Centers for Disease Control and Prevention, Kisumu, Kenya.
authors.forename: Muthoni
authors.initials: M
authors.lastname: Junghae
authors.affiliation: Kenya Medical Research Institute/Centers for Disease Control and Prevention, Kisumu, Kenya.
authors.forename: Robert F
authors.initials: RF
authors.lastname: Breiman
authors.affiliation: Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, GA.
authors.forename: Cynthia G
authors.initials: CG
authors.lastname: Whitney
authors.affiliation: Kenya Medical Research Institute/Centers for Disease Control and Prevention, Kisumu, Kenya.
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Feikin
authors.affiliation: Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, GA.
authors.forename: Laura M
authors.initials: LM
authors.lastname: Conklin
mesh_terms: D000293:Adolescent; D000328:Adult; D000349:Africa; D000368:Aged; D000369:Aged, 80 and over; D000941:Antigens; D000942:Antigens, Bacterial / Q000652:urine*; D003955:Diagnostic Tests, Routine / Q000379:methods*; D005260:Female; D006801:Humans; D007118:Immunoassay / Q000379:methods*; D007630:Kenya; D008297:Male; D008875:Middle Aged; D011008:Pneumococcal Infections / Q000175:diagnosis*; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D000941:Antigens; D000942:Antigens, Bacterial
keywords: Africa; HIV; Kenya; Nasopharyngeal colonization; Pneumococcus; Streptococcus pneumoniae; Urine pneumococcal antigen test