Cookies on this website

We use cookies to ensure that we give you the best experience on our website. If you click 'Accept all cookies' we'll assume that you are happy to receive all cookies and you won't see this message again. If you click 'Reject all non-essential cookies' only necessary cookies providing core functionality such as security, network management, and accessibility will be enabled. Click 'Find out more' for information on how to change your cookie settings.

ObjectiveTo evaluate the performance and feasibility of FASTPlaqueTB in smear-negative tuberculosis (TB) suspects in a peripheral clinic after laboratory upgrading.DesignPatients with cough > or=2 weeks, two sputum smear-negative results, no response to 1 week of amoxicillin and abnormal chest X-ray were defined as smear-negative suspects. One sputum sample was collected, decontaminated and divided into two: half was tested with FASTPlaqueTB in the clinic laboratory and the other half was cultured on Löwenstein-Jensen medium in the Kenyan Medical Research Institute. Test sensitivity and specificity were evaluated in all patients and in human immunodeficiency virus (HIV) infected patients. Feasibility was assessed by the contamination rate and the resources required to upgrade the laboratory.ResultsOf 208 patients included in the study, 56.2% were HIV-infected. Of 203 FASTPlaqueTB tests, 95 (46.8%) were contaminated, which interfered with result interpretation and led to the interruption of the study. Sensitivity and specificity were respectively 31.2% (95%CI 12.1-58.5) and 94.9% (95%CI 86.8-98.4) in all patients and 33.3% (95%CI 9.9-65.1) and 93.9% (95%CI 83.1-98.7) in HIV-infected patients. Upgrading the laboratory cost euro 20,000.ConclusionFASTPlaqueTB did not perform satisfactorily in this setting. If contamination can be reduced, in addition to laboratory upgrading, its introduction in peripheral clinics would require further assessment in smear-negative and HIV co-infected patients and test adaptation for friendlier use.

Type

Journal article

Journal

The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease

Publication Date

09/2009

Volume

13

Pages

1112 - 1118

Addresses

Epicentre, Paris, France. maryline.bonnet@geneva.msf.org

Keywords

Sputum, Humans, Mycobacterium tuberculosis, Tuberculosis, Pulmonary, HIV Infections, Cough, Amoxicillin, Anti-Bacterial Agents, Reagent Kits, Diagnostic, Observer Variation, Radiography, Specimen Handling, Bacteriological Techniques, Colony Count, Microbial, Sensitivity and Specificity, Prospective Studies, Feasibility Studies, Reproducibility of Results, Predictive Value of Tests, Air Microbiology, Developing Countries, Adult, Middle Aged, Ambulatory Care Facilities, Kenya, Female, Male