Back to Journals » Clinical Epidemiology » Volume 3 » Issue 1

Diagnostic value of an immunochromatographic test over clinical predictors for tuberculosis in HIV patients

Authors Nanta S, Kantipong, Pathipvanich, Ruengorn C, Tawichasri, Patumanond J

Published 12 September 2011 Volume 2011:3(1) Pages 237—244

DOI https://doi.org/10.2147/CLEP.S24668

Review by Single-blind

Peer reviewer comments 3


Sirisak Nanta1,2, Patcharee Kantipong3, Panita Pathipvanich4, Chidchanok Ruengorn5, Chamaiporn Tawichasri1, Jayanton Patumanond1
1Clinical Epidemiology Program, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; 2Maesai District Hospital, Maesai, Chiang Rai, Thailand; 3Chiang Rai Regional Hospital, Chiang Rai, Thailand; 4Lampang Regional Hospital, Lampang, Thailand; 5Department of Pharmaceutical Care, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, Thailand

Purpose: The value of an immunochromatographic test for tuberculosis (ICT-TB) combined with clinical predictors has yet to be evaluated in Thailand. This study aimed to assess any additional diagnostic value of an ICT-TB test over that of clinical predictors in a group of human immunodeficiency virus (HIV) patients as well as in subgroups of HIV patients classified by clinical risk scores.
Patients and methods: An extended cross-sectional study was conducted at a community hospital in Chiang Rai and a general hospital in Lampang. HIV patients registered between April 2009 and May 2010 were screened by a locally made ICT-TB test, including 38, 16, and 6 kD Microbacterium tuberculosis antigens, as well as by routine evaluations for TB diagnosis. Demographic data, medical history, signs, and symptoms were recorded. Participants were followed up for 2 months for final ascertainment of TB diagnosis.
Results: Of 206 patients, 37 (18%) had TB. Four clinical predictors were identified: low body mass index (<19 kg/m2), prolonged cough (duration >2 weeks), shaking chills (≥1 week), and no use of antiretrovirals. The area under the receiver operating curve was 90.2%; adding the ICT-TB test result increased the area nonsignificantly to 91.6% (P = 0.40). When patients were categorized by risk scores derived from selected clinical predictors into low (scores ≤7) and high (scores >7) TB risk groups, a positive ICT-TB test increased the positive predictive value nonsignificantly in the low risk group (from 12.5% to 27.3%, P = 0.17) and the high risk group (from 78.6% to 80.8%, P = 0.73).
Conclusion: In this study setting, the ICT-TB test did not enhance TB diagnosis over the four clinical predictors in the overall group or any subgroups of HIV patients classified by clinical risk scores.

Keywords: diagnostic test, signs, symptoms, TB

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]