{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:27:11Z","timestamp":1792787231468,"version":"4.5.0"},"reference-count":32,"publisher":"American Society for Microbiology","license":[{"start":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T00:00:00Z","timestamp":1791763200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T00:00:00Z","timestamp":1791763200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["T32 AI007044"],"award-info":[{"award-number":["T32 AI007044"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"name":"National Research Program for","award":["5213\/Sindh\/NRPU\/R&D\/HEC\/2026"],"award-info":[{"award-number":["5213\/Sindh\/NRPU\/R&D\/HEC\/2026"]}]},{"name":"University of Virginia Global Infectious Disease Institute","id":[{"id":"https:\/\/ror.org\/0153tk833","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["J Clin Microbiol"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>Urinary assays detecting lipoarabinomannan (LAM) as a diagnostic test for tuberculosis (TB) have limited sensitivity in pediatric populations. We aimed to evaluate the Ceres TB-Nanotrap to concentrate LAM and augment detection in urine using the Alere lateral flow assay (LF-LAM). This case-control study recruited 32 children with and without TB aged 1\u201318 years in Karachi, Pakistan, with banked urine specimens. TB case participants were classified as confirmed or unconfirmed TB using modified National Institutes of Health (NIH) consensus criteria. The LF-LAM test was performed before and after concentrating 5 mL of urine with TB-Nanotrap particles. Band intensity was measured via visual grading and digital quantification. Urine LAM sensitivity by visual grading was 4.5% (95% confidence interval [CI] 0.3\u201318.5) pre-concentration and 50.0% (95% CI 30.0\u201370.0) post-concentration. Sensitivity by digital quantification was 0.0% (95% CI 0.0\u201315.4) pre-concentration and 63.9% (95% CI 42.8\u201381.4) post-concentration. Specificity was high with both methods (visual grading: 90.0% [95% CI 62.8\u201399.4] pre-concentration and 90.0% [95% CI 62.8\u201399.4] post-concentration; digital analysis: 80.0% [95% CI 44.4\u201397.5] and 90.0% [95% CI 62.8\u201399.4], respectively). For cases, digital analysis showed an increase in median LF-LAM band intensity from 0.0 arbitrary units (AU) (interquartile range [IQR] 0.00\u201332.5) in unconcentrated samples to 98.4 AU (IQR 34.9\u2013212.2) in concentrated samples. Concentration with TB-Nanotrap greatly increased sensitivity of urine LAM detection without a change in specificity. Use of TB-Nanotrap and digital quantitative analysis of urine LAM improved the diagnostic accuracy of the LF-LAM assay in this pediatric population and should be validated in larger studies.<\/jats:p>\n                    <jats:sec>\n                      <jats:title>IMPORTANCE<\/jats:title>\n                      <jats:p>Diagnosing TB in children is challenging due to a lack of accurate and accessible diagnostic tests. In this study, we evaluated two methods of improving detection of TB in children using a commercially available urine test. First, we processed the urine to concentrate any available TB antigens. Second, we included a digital reader to interpret the test results. We found that concentrating urine and using a digital reader led to an increase in TB detection among children who had been diagnosed with TB, while minimizing false-positive results among children who did not have TB.<\/jats:p>\n                    <\/jats:sec>\n                  <\/jats:sec>","DOI":"10.1128\/jcm.01559-25","type":"journal-article","created":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T13:01:26Z","timestamp":1791810086000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":0,"title":["Nanoparticle capture of urinary lipoarabinomannan for diagnosing childhood tuberculosis"],"prefix":"10.1128","author":[{"given":"Kumail","family":"Ahmed","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03gd0dm95","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Paediatrics and Child Health, Aga Khan University","place":["Karachi, Pakistan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-1701-4920","authenticated-orcid":true,"given":"Brendan T.","family":"Mullen","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/0153tk833","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Internal Medicine, University of Virginia","place":["Charlottesville, USA"]},{"name":"Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington","place":["Seattle, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Najeeha T.","family":"Iqbal","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03gd0dm95","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Paediatrics and Child Health, Aga Khan University","place":["Karachi, Pakistan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3929-6369","authenticated-orcid":true,"given":"Tania A.","family":"Thomas","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/0153tk833","id-type":"ROR","asserted-by":"publisher"}],"name":"Division of Infectious Diseases and International Health, University of Virginia","place":["Charlottesville, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","published-online":{"date-parts":[[2026,10,12]]},"reference":[{"key":"e_1_3_4_2_2","volume-title":"Global tuberculosis report","author":"World Health Organization","year":"2018","unstructured":"World Health Organization. 2018. Global tuberculosis report. World Health Organization, Geneva, Switzerland."},{"key":"e_1_3_4_3_2","volume-title":"Roadmap for childhood tuberculosis: towards zero deaths","author":"World Health Organization","year":"2013","unstructured":"World Health Organization. 2013. Roadmap for childhood tuberculosis: towards zero deaths. World Health Organization, Geneva, Switzerland."},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.j1341"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)60359-5"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0167-7012(01)00239-1"},{"key":"e_1_3_4_7_2","volume-title":"The use of lateral flow urine lipoarabinomannan assay (LF-LAM) for the diagnosis and screening of active tuberculosis in people living with HIV: policy guidance","author":"World Health Organization","year":"2015","unstructured":"World Health Organization. 2015. The use of lateral flow urine lipoarabinomannan assay (LF-LAM) for the diagnosis and screening of active tuberculosis in people living with HIV: policy guidance World Health Organization, Geneva, Switzerland."},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.5588\/ijtld.13.0526"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00003315"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD011420.pub3"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pgph.0000672"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.biomaterials.2010.10.004"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.nano.2017.11.020"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1111\/2049-632X.12136"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1126\/scitranslmed.aal2807"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1128\/mSphere.00632-19"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/civ581"},{"key":"e_1_3_4_18_2","unstructured":"Stop TB Partnership\/Global Drug Facility. 2018. Alere determine TB LAM ag assay for detection of Mycobacterium Tuberculosis complex mentor4TB Toolkit. StopTB. Geneva Switzerland"},{"key":"e_1_3_4_19_2","volume-title":"Determine TB LAM Ag: package insert","year":"2023","unstructured":"2023. Determine TB LAM Ag: package insert Abbott, Chicago, IL, USA."},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.2471\/B09111"},{"key":"e_1_3_4_21_2","volume-title":"Lateral flow urine lipoarabinomannan assay (LF-LAM) for the diagnosis of active tuberculosis in people living with hiv: policy update","author":"World Health Organization","year":"2019","unstructured":"World Health Organization. 2019. Lateral flow urine lipoarabinomannan assay (LF-LAM) for the diagnosis of active tuberculosis in people living with hiv: policy update World Health Organization, Geneva, Switzerland."},{"key":"e_1_3_4_22_2","volume-title":"Tuberculosis diagnostics pipeline report","author":"Branigan D","year":"2023","unstructured":"Branigan D. 2023. Tuberculosis diagnostics pipeline report. Treatment Action Group, New York, NY, USA."},{"key":"e_1_3_4_23_2","doi-asserted-by":"publisher","DOI":"10.3390\/s19214812"},{"key":"e_1_3_4_24_2","doi-asserted-by":"publisher","DOI":"10.3390\/jof9020217"},{"key":"e_1_3_4_25_2","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000002002"},{"key":"e_1_3_4_26_2","volume-title":"The Union World Conference On Lung Health","author":"Makumbi S","year":"2023","unstructured":"Makumbi S. 2023. Yield and operational challenges of including urine LAM testing in intensified TB case-594 finding among outpatients with HIV: Experience from the TB-SCRIPT trial. The Union World Conference On Lung Health."},{"key":"e_1_3_4_27_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm9010111"},{"key":"e_1_3_4_28_2","doi-asserted-by":"publisher","DOI":"10.1172\/JCI140461"},{"key":"e_1_3_4_29_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.01338-18"},{"key":"e_1_3_4_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(22)00463-6"},{"key":"e_1_3_4_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(19)30475-X"},{"key":"e_1_3_4_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(19)30684-X"},{"key":"e_1_3_4_33_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cix513"}],"container-title":["Journal of Clinical Microbiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/jcm.01559-25","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/jcm.01559-25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T13:01:33Z","timestamp":1791810093000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.asm.org\/doi\/10.1128\/jcm.01559-25"}},"subtitle":[],"editor":[{"given":"Mark","family":"Nicol","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,10,12]]},"references-count":32,"alternative-id":["10.1128\/jcm.01559-25"],"URL":"https:\/\/doi.org\/10.1128\/jcm.01559-25","relation":{},"ISSN":["0095-1137","1098-660X"],"issn-type":[{"value":"0095-1137","type":"print"},{"value":"1098-660X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,12]]},"assertion":[{"value":"2025-10-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-26","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-12","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e01559-25"}}