{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T13:00:52Z","timestamp":1791378052909,"version":"4.3.2"},"reference-count":31,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T00:00:00Z","timestamp":1753660800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Research Council of Norway","award":["234457"],"award-info":[{"award-number":["234457"]}]},{"name":"EDCTP2 program","award":["234457"],"award-info":[{"award-number":["234457"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Extrapulmonary tuberculosis (EPTB) remains diagnostically challenging due to its paucibacillary nature and variable presentation. Xpert and culture are limited in EPTB diagnosis due to sampling challenges, low sensitivity, and long turnaround times. This study evaluated the performance of the MPT64 antigen detection test for diagnosing EPTB, particularly tuberculous lymphadenitis (TBLN) and tuberculous pleuritis (TBP), in a high-TB, low-HIV setting. Conducted at Gulab-Devi Hospital, Lahore, Pakistan, this study evaluated the MPT64 test\u2019s performance against conventional diagnostic methods, including culture, histopathology, and the Xpert MTB\/RIF assay. Lymph node biopsies were collected, and cell blocks were made from aspirated pleural fluid from patients clinically presumed to have EPTB. Of 338 patients, 318 (94%) were diagnosed with EPTB. For TBLN, MPT64 demonstrated higher sensitivity (84%) than Xpert (48%); for TBP, the sensitivity was 51% versus 7%, respectively. Among histopathology-confirmed TBLN cases, MPT64 outperformed both culture and Xpert (85% vs. 58% and 47%). Due to the low number of non-TB cases, specificity could not be reliably assessed. The MPT64 test shows promise as a rapid, sensitive diagnostic tool for EPTB, particularly TBLN, in routine settings. While sensitivity is notably superior to Xpert, further studies are needed to evaluate its specificity and broader diagnostic utility.<\/jats:p>","DOI":"10.3390\/pathogens14080741","type":"journal-article","created":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T10:51:14Z","timestamp":1753699874000},"page":"741","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Advancing Extrapulmonary Tuberculosis Diagnosis: Potential of MPT64 Immunochemistry-Based Antigen Detection Test in a High-TB, Low-HIV Endemic Setting"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1484-244X","authenticated-orcid":false,"given":"Ahmad","family":"Wali","sequence":"first","affiliation":[{"name":"Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Arstadveien 21, 5009 Bergen, Norway"},{"name":"Department of Health, Government of Balochistan, Civil Secretariat, Zarghoon Road, Quetta 87300, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nauman","family":"Safdar","sequence":"additional","affiliation":[{"name":"Interactive Research and Development, Level 10, One George Street, Singapore 049145, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2165-4444","authenticated-orcid":false,"given":"Atiqa","family":"Ambreen","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Gulab Devi Teaching Hospital, Lahore 05441, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2716-5027","authenticated-orcid":false,"given":"Asif","family":"Loya","sequence":"additional","affiliation":[{"name":"Department of Pathology, Shaukat Khanum Memorial Cancer Hospital and Research Center, 7A Block R-3 MA Johar Town, Lahore 54000, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9822-1191","authenticated-orcid":false,"given":"Tehmina","family":"Mustafa","sequence":"additional","affiliation":[{"name":"Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Arstadveien 21, 5009 Bergen, Norway"},{"name":"Department of Thoracic Medicine, Haukeland University Hospital, Bergen, Haukelandsveien 22, 5009 Bergen, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,28]]},"reference":[{"key":"ref_1","first-page":"1","article-title":"Laboratory Diagnosis of Extrapulmonary Tuberculosis (EPTB) in Resource- constrained Setting: State of the Art, Challenges and the Need","volume":"9","author":"Purohit","year":"2015","journal-title":"J. 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