LAMP minimal dataset

Harvard | Vancouver

Nliwasa, M, MacPherson, P, Chisala, P, Kamdolozi, M, Khundi, MJ, Kaswaswa, K, Mwapasa, M, Msefula, C, Sohn, H, Flach, C and Corbett, E. 2016. LAMP minimal dataset. [Online]. PLoS One. Available from: 10.1371/journal.pone.0155101.s001

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Current tuberculosis diagnostics lack sensitivity, and are expensive. Highly accurate, rapid and cheaper diagnostic tests are required for point of care use in low resource settings with high HIV prevalence. To investigate the sensitivity and specificity, and cost of loop-mediated isothermal amplification (LAMP) assay for tuberculosis diagnosis in adults with chronic cough compared to Xpert® MTB/RIF, fluorescence smear microscopy. Between October 2013 and March 2014, consecutive adults at a primary care clinic were screened for cough, offered HIV testing and assessed for tuberculosis using LAMP, Xpert® MTB/RIF and fluorescence smear microscopy. Sensitivity and specificity (with culture as reference standard), and costs were estimated. Of 273 adults recruited, 44.3% (121/273) were HIV-positive and 19.4% (53/273) had bacteriogically confirmed tuberculosis. The sensitivity of LAMP compared to culture was 65.0% (95% CI: 48.3% to 79.4%) with 100% (95% CI: 98.0% to 100%) specificity. The sensitivity of Xpert® MTB/RIF (77.5%, 95% CI: 61.5% to 89.2%) was similar to that of LAMP, p = 0.132. The sensitivity of concentrated fluorescence smear microscopy with routine double reading (87.5%, 95% CI: 73.2% to 95.8%) was higher than that of LAMP, p = 0.020. All three tests had high specificity. The lowest cost per test of LAMP was at batch size of 14 samples (US$ 9.98); this was lower than Xpert® MTB/RIF (US$ 13.38) but higher than fluorescence smear microscopy (US$ 0.65). The sensitivity of LAMP was similar to Xpert® MTB/RIF but lower than fluorescence smear microscopy; all three tests had high specificity. These findings support the Malawi policy that recommends a combination of fluorescence smear microscopy and Xpert® MTB/RIF prioritised for people living with HIV, already found to be smear-negative, or being considered for retreatment of tuberculosis.

Published in a 3rd party system Date: 12 May 2016
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Mode of data capture
Experiment: Field Intervention
Data Creators(s): Nliwasa, M, MacPherson, P, Chisala, P, Kamdolozi, M, Khundi, MJ, Kaswaswa, K, Mwapasa, M, Msefula, C, Sohn, H, Flach, C and Corbett, E
LSHTM Faculty/Department: Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Faculty of Infectious and Tropical Diseases > Dept of Clinical Research
Participating Institutions: London School of Hygiene & Tropical Medicine, Liverpool School of Tropical Medicine, College of Medicine, Blantyre, Malawi, McGill University

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