| |  Online-Ressource |
|---|
| Verfasst von: | Dhana, Ashar [VerfasserIn]  |
|---|
| | Hamada, Yohhei [VerfasserIn] |
|---|
| | Kengne, Andre P. [VerfasserIn] |
|---|
| | Kerkhoff, Andrew D. [VerfasserIn] |
|---|
| | Broger, Tobias [VerfasserIn] |
|---|
| | Denkinger, Claudia M. [VerfasserIn] |
|---|
| | Rangaka, Molebogeng X. [VerfasserIn] |
|---|
| | Gupta-Wright, Ankur [VerfasserIn] |
|---|
| | Fielding, Katherine [VerfasserIn] |
|---|
| | Wood, Robin [VerfasserIn] |
|---|
| | Huerga, Helena [VerfasserIn] |
|---|
| | Rücker, Sekai Chenai Mathabire [VerfasserIn] |
|---|
| | Bjerrum, Stephanie [VerfasserIn] |
|---|
| | Johansen, Isik S. [VerfasserIn] |
|---|
| | Thit, Swe Swe [VerfasserIn] |
|---|
| | Kyi, Mar Mar [VerfasserIn] |
|---|
| | Hanson, Josh [VerfasserIn] |
|---|
| | Barr, David A. [VerfasserIn] |
|---|
| | Meintjes, Graeme [VerfasserIn] |
|---|
| | Maartens, Gary [VerfasserIn] |
|---|
| Titel: | Diagnostic accuracy of WHO screening criteria to guide lateral-flow lipoarabinomannan testing among HIV-positive inpatients |
|---|
| Titelzusatz: | a systematic review and individual participant data meta-analysis |
|---|
| Verf.angabe: | Ashar Dhana, Yohhei Hamada, Andre P. Kengne, Andrew D. Kerkhoff, Tobias Broger, Claudia M. Denkinger, Molebogeng X. Rangaka, Ankur Gupta-Wright, Katherine Fielding, Robin Wood, Helena Huerga, Sekai Chenai Mathabire Rücker, Stephanie Bjerrum, Isik S. Johansen, Swe Swe Thit, Mar Mar Kyi, Josh Hanson, David A. Barr, Graeme Meintjes, Gary Maartens |
|---|
| E-Jahr: | 2022 |
|---|
| Jahr: | 16 May 2022 |
|---|
| Umfang: | 9 S. |
|---|
| Fussnoten: | Gesehen am 16.08.2022 |
|---|
| Titel Quelle: | Enthalten in: Journal of infection |
|---|
| Ort Quelle: | Amsterdam [u.a.] : Elsevier, 1979 |
|---|
| Jahr Quelle: | 2022 |
|---|
| Band/Heft Quelle: | 85(2022), 1, Seite 40-48 |
|---|
| ISSN Quelle: | 1532-2742 |
|---|
| Abstract: | BACKGROUND: WHO recommends urine lateral-flow lipoarabinomannan (LF-LAM) testing with AlereLAM in HIV-positive inpatients only if screening criteria are met. We assessed the performance of WHO screening criteria and alternative screening tests/strategies to guide LF-LAM testing and compared diagnostic accuracy of the WHO AlereLAM algorithm (WHO screening criteria followed by AlereLAM if screen positive) with AlereLAM and FujiLAM (a novel LF-LAM test) testing in all HIV-positive inpatients. - METHODS: We searched MEDLINE, Embase, and Cochrane Library from Jan 1, 2011 to March 1, 2020 for studies among adult/adolescent HIV-positive inpatients regardless of tuberculosis signs and symptoms. The reference standards were (1) AlereLAM or FujiLAM for screening tests/strategies and (2) culture or Xpert for AlereLAM/FujiLAM. We determined proportion of inpatients eligible for AlereLAM using WHO screening criteria; assessed accuracy of WHO criteria and alternative screening tests/strategies to guide LF-LAM testing; compared accuracy of WHO AlereLAM algorithm with AlereLAM/FujiLAM testing in all; and determined diagnostic yield of AlereLAM, FujiLAM, and Xpert MTB/RIF (Xpert). We estimated pooled proportions with a random-effects model, assessed diagnostic accuracy using random-effects bivariate models, and assessed diagnostic yield descriptively. - FINDINGS: We obtained data from all 5 identified studies (n = 3,504). The pooled proportion of inpatients eligible for AlereLAM using WHO criteria was 93% (95%CI 91, 95). Among screening tests/strategies to guide LF-LAM testing, WHO criteria, C-reactive protein (≥5 mg/L), and CD4 count (<200 cells/μL) had high sensitivities but low specificities; cough (≥2 weeks), hemoglobin (<8 g/dL), body mass index (<18.5 kg/m2), lymphadenopathy, and WHO-defined danger signs had higher specificities but suboptimal sensitivities. AlereLAM in all had the same sensitivity (62%) and specificity (88%) as WHO AlereLAM algorithm. Sensitivity of FujiLAM and AlereLAM was 69% and 48%, while specificity was 88% and 96%, respectively. In 2 studies that collected sputum and non-sputum samples for Xpert and/or culture, diagnostic yield of sputum Xpert was 40-41%, AlereLAM was 39-76%, and urine Xpert was 35-62%. In one study, FujiLAM diagnosed 80% of tuberculosis cases (vs 39% for AlereLAM), and sputum Xpert combined with AlereLAM, urine Xpert, or FujiLAM diagnosed 61%, 81%, and 92% of all cases, respectively. - INTERPRETATION: WHO criteria and alternative screening tests/strategies have limited utility in guiding LF-LAM testing, suggesting that AlereLAM testing in all HIV-positive medical inpatients be implemented. Routine FujiLAM may improve tuberculosis diagnosis. - FUNDING: None. |
|---|
| DOI: | doi:10.1016/j.jinf.2022.05.010 |
|---|
| URL: | Bitte beachten Sie: Dies ist ein Bibliographieeintrag. Ein Volltextzugriff für Mitglieder der Universität besteht hier nur, falls für die entsprechende Zeitschrift/den entsprechenden Sammelband ein Abonnement besteht oder es sich um einen OpenAccess-Titel handelt.
Volltext: https://doi.org/10.1016/j.jinf.2022.05.010 |
|---|
| | DOI: https://doi.org/10.1016/j.jinf.2022.05.010 |
|---|
| Datenträger: | Online-Ressource |
|---|
| Sprache: | eng |
|---|
| Sach-SW: | Adolescent |
|---|
| | Adult |
|---|
| | Diagnosis |
|---|
| | HIV Infections |
|---|
| | HIV Seropositivity |
|---|
| | Human immunodeficiency virus |
|---|
| | Humans |
|---|
| | Inpatient |
|---|
| | Inpatients |
|---|
| | LAM |
|---|
| | Lipoarabinomannan |
|---|
| | Lipopolysaccharides |
|---|
| | Mycobacterium tuberculosis |
|---|
| | Screening |
|---|
| | Sensitivity |
|---|
| | Sensitivity and Specificity |
|---|
| | Specificity |
|---|
| | Sputum |
|---|
| | Tuberculosis |
|---|
| | World Health Organization |
|---|
| K10plus-PPN: | 181441620X |
|---|
| Verknüpfungen: | → Zeitschrift |
|---|
Diagnostic accuracy of WHO screening criteria to guide lateral-flow lipoarabinomannan testing among HIV-positive inpatients / Dhana, Ashar [VerfasserIn]; 16 May 2022 (Online-Ressource)
