{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T10:17:29Z","timestamp":1789208249434,"version":"build-2803163510"},"reference-count":22,"publisher":"European Respiratory Society (ERS)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Eur Respir J"],"accepted":{"date-parts":[[2012,2,8]]},"published-print":{"date-parts":[[2012,11]]},"abstract":"<jats:p>Lack of point-of-care tests for tuberculosis (TB) result in diagnostic delay, and increased mortality and healthcare-related costs.<\/jats:p><jats:p>The urine Determine<jats:sup>TM<\/jats:sup>TB-LAM point-of-care strip-test was evaluated in 335 prospectively-recruited hospitalised patients with suspected TB-HIV co-infection (group 1) and from 88 HIV-infected hospitalised patients with non-TB diagnoses (group 2). Cut-off point-specific analyses were performed using: 1) a microbiological reference standard (culture positive<jats:italic>versus<\/jats:italic>negative); and 2) a composite reference standard (exclusion of patients with clinical-TB from the culture-negative group).<\/jats:p><jats:p>Using the microbiological reference and the manufacturer-recommended grade-1 cut-off point, LAM sensitivity and specificity was 66% (95% CI 57\u201374%). By contrast, using the composite reference sensitivity was 60% (95% CI 53\u201367%) and specificity improved to 96% (95% CI 89\u2013100%) (p=0.001). The same pattern was seen when the grade-2 cut-off point was used (specificity 75%<jats:italic>versus<\/jats:italic>96%; p=0.01). In group two patients specificity was poor using the grade-1 cut-off point, but improved significantly when the grade-2 cut-off point was used (90%<jats:italic>versus<\/jats:italic>99%; p=0.009). The grade-2 cut-off point also offered superior inter-reader reliability (p=0.002). Sensitivity was highest in those with a CD4 &lt;200 cells per mL. LAM combined with smear-microscopy was able to rule-in TB in 71% of<jats:italic>Mycobacterium tuberculosis<\/jats:italic>culture-positive patients.<\/jats:p><jats:p>This preliminary study indicates that the LAM strip-test may be a potentially useful rapid rule-in test for TB in hospitalised patients with advanced immunosuppression. The grade 2, but not the manufacturer-recommended grade 1 cut-off point, offered superior rule-in utility and inter-reader reliability. Larger studies to evaluate cut-off points and diagnostic accuracy are urgently required.<\/jats:p>","DOI":"10.1183\/09031936.00201711","type":"journal-article","created":{"date-parts":[[2012,2,24]],"date-time":"2012-02-24T03:59:04Z","timestamp":1330055944000},"page":"1211-1220","source":"Crossref","is-referenced-by-count":101,"title":["Diagnostic accuracy of a urine lipoarabinomannan strip-test for TB detection in HIV-infected hospitalised patients"],"prefix":"10.1183","volume":"40","author":[{"given":"Jonathan G.","family":"Peter","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grant","family":"Theron","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"van Zyl-Smit","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asheen","family":"Haripersad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lynelle","family":"Mottay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Kraus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anke","family":"Binder","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Meldau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anneli","family":"Hardy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keertan","family":"Dheda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"81","published-online":{"date-parts":[[2012,2,23]]},"reference":[{"key":"2024102021030190000_40.5.1211.1","unstructured":"WHO. Global tuberculosis control 2010. WHO\/HTM\/TB\/2010.7. Geneva, World Health Organisation, 2010."},{"key":"2024102021030190000_40.5.1211.2","doi-asserted-by":"publisher","DOI":"10.1086\/651492"},{"key":"2024102021030190000_40.5.1211.3","unstructured":"Harrison D . An overview of health and health care in South Africa 1994\u20132010: priorities, progress and prospects for new gains; 2009. Online report"},{"key":"2024102021030190000_40.5.1211.4","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(11)70057-3"},{"key":"2024102021030190000_40.5.1211.5","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000296"},{"key":"2024102021030190000_40.5.1211.6","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0907488"},{"key":"2024102021030190000_40.5.1211.7","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200905-0692OC"},{"key":"2024102021030190000_40.5.1211.8","doi-asserted-by":"publisher","DOI":"10.1586\/erm.10.67"},{"key":"2024102021030190000_40.5.1211.9","doi-asserted-by":"publisher","DOI":"10.1111\/j.1574-6976.2011.00276.x"},{"key":"2024102021030190000_40.5.1211.10","doi-asserted-by":"publisher","DOI":"10.1016\/S0167-7012(01)00239-1"},{"key":"2024102021030190000_40.5.1211.11","doi-asserted-by":"publisher","DOI":"10.1080\/00365540110077263"},{"key":"2024102021030190000_40.5.1211.12","doi-asserted-by":"publisher","DOI":"10.1097\/MCP.0b013e328337f23a"},{"key":"2024102021030190000_40.5.1211.13","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00025711"},{"key":"2024102021030190000_40.5.1211.14","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0b013e31822b75d4"},{"key":"2024102021030190000_40.5.1211.15","doi-asserted-by":"publisher","DOI":"10.1128\/CVI.05205-11"},{"key":"2024102021030190000_40.5.1211.16","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0b013e3181b98430"},{"key":"2024102021030190000_40.5.1211.17","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e32832e05c8"},{"key":"2024102021030190000_40.5.1211.18","unstructured":"Alere. Alere Determine TB LAM Ag rapid test product listing. 2011. www.alerehiv.com\/hiv-comorbidities\/features ."},{"key":"2024102021030190000_40.5.1211.19","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(11)70251-1"},{"key":"2024102021030190000_40.5.1211.20","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0009848"},{"key":"2024102021030190000_40.5.1211.21","doi-asserted-by":"publisher","DOI":"10.2307\/2529310"},{"key":"2024102021030190000_40.5.1211.22","first-page":"639","article-title":"The STARD statement for reporting studies of diagnostic accuracy: explanation and elaboration. The standards for reporting of diagnostic accuracy group","volume":"44","author":"Bossuyt","year":"2003","journal-title":"Croat Med J"}],"container-title":["European Respiratory Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1183\/09031936.00201711","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,24]],"date-time":"2025-02-24T06:35:35Z","timestamp":1740378935000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.ersnet.org\/lookup\/doi\/10.1183\/09031936.00201711"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,2,23]]},"references-count":22,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2012,10,31]]},"published-print":{"date-parts":[[2012,11]]}},"alternative-id":["10.1183\/09031936.00201711"],"URL":"https:\/\/doi.org\/10.1183\/09031936.00201711","relation":{},"ISSN":["0903-1936","1399-3003"],"issn-type":[{"value":"0903-1936","type":"print"},{"value":"1399-3003","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,2,23]]}}}