Diagnostic accuracy of WHO screening criteria to guide lateral-flow lipoarabinomannan testing among HIV-positive inpatients : a systematic review and individual participant data meta-analysis
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 diagnost...
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Gespeichert in:
| Autor*in: |
Dhana, Ashar [verfasserIn] Hamada, Yohhei [verfasserIn] Kengne, Andre P. [verfasserIn] Kerkhoff, Andrew D. [verfasserIn] Broger, Tobias [verfasserIn] Denkinger, Claudia M. - 1978- [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] |
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| Format: |
E-Artikel |
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| Sprache: |
Englisch |
| Erschienen: |
16 May 2022 |
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| Schlagwörter: |
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| Anmerkung: |
Gesehen am 16.08.2022 |
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| Umfang: |
9 |
| Übergeordnetes Werk: |
Enthalten in: Journal of infection - Amsterdam [u.a.] : Elsevier, 1979, 85(2022), 1, Seite 40-48 |
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| Übergeordnetes Werk: |
volume:85 ; year:2022 ; number:1 ; pages:40-48 ; extent:9 |
| Links: |
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| DOI / URN: |
10.1016/j.jinf.2022.05.010 |
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| Katalog-ID: |
181441620X |
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| 100 | 1 | |a Dhana, Ashar |e verfasserin |0 (DE-588)1265528349 |0 (DE-627)1814417869 |4 aut | |
| 245 | 1 | 0 | |a Diagnostic accuracy of WHO screening criteria to guide lateral-flow lipoarabinomannan testing among HIV-positive inpatients |b a systematic review and individual participant data meta-analysis |c 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 |
| 264 | 1 | |c 16 May 2022 | |
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| 500 | |a Gesehen am 16.08.2022 | ||
| 520 | |a 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. | ||
| 650 | 4 | |a Adolescent | |
| 650 | 4 | |a Adult | |
| 650 | 4 | |a Diagnosis | |
| 650 | 4 | |a HIV Infections | |
| 650 | 4 | |a HIV Seropositivity | |
| 650 | 4 | |a Human immunodeficiency virus | |
| 650 | 4 | |a Humans | |
| 650 | 4 | |a Inpatient | |
| 650 | 4 | |a Inpatients | |
| 650 | 4 | |a LAM | |
| 650 | 4 | |a Lipoarabinomannan | |
| 650 | 4 | |a Lipopolysaccharides | |
| 650 | 4 | |a Mycobacterium tuberculosis | |
| 650 | 4 | |a Screening | |
| 650 | 4 | |a Sensitivity | |
| 650 | 4 | |a Sensitivity and Specificity | |
| 650 | 4 | |a Specificity | |
| 650 | 4 | |a Sputum | |
| 650 | 4 | |a Tuberculosis | |
| 650 | 4 | |a World Health Organization | |
| 700 | 1 | |a Hamada, Yohhei |e verfasserin |4 aut | |
| 700 | 1 | |a Kengne, Andre P. |e verfasserin |4 aut | |
| 700 | 1 | |a Kerkhoff, Andrew D. |e verfasserin |4 aut | |
| 700 | 1 | |a Broger, Tobias |e verfasserin |0 (DE-588)1208538853 |0 (DE-627)1694882047 |4 aut | |
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| 700 | 1 | |a Rangaka, Molebogeng X. |e verfasserin |4 aut | |
| 700 | 1 | |a Gupta-Wright, Ankur |e verfasserin |4 aut | |
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| 700 | 1 | |a Wood, Robin |e verfasserin |4 aut | |
| 700 | 1 | |a Huerga, Helena |e verfasserin |4 aut | |
| 700 | 1 | |a Rücker, Sekai Chenai Mathabire |e verfasserin |4 aut | |
| 700 | 1 | |a Bjerrum, Stephanie |e verfasserin |4 aut | |
| 700 | 1 | |a Johansen, Isik S. |e verfasserin |4 aut | |
| 700 | 1 | |a Thit, Swe Swe |e verfasserin |4 aut | |
| 700 | 1 | |a Kyi, Mar Mar |e verfasserin |4 aut | |
| 700 | 1 | |a Hanson, Josh |e verfasserin |4 aut | |
| 700 | 1 | |a Barr, David A. |e verfasserin |4 aut | |
| 700 | 1 | |a Meintjes, Graeme |e verfasserin |4 aut | |
| 700 | 1 | |a Maartens, Gary |e verfasserin |4 aut | |
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10.1016/j.jinf.2022.05.010 doi (DE-627)181441620X (DE-599)KXP181441620X (OCoLC)1361706433 DE-627 ger DE-627 rda eng Dhana, Ashar verfasserin (DE-588)1265528349 (DE-627)1814417869 aut Diagnostic accuracy of WHO screening criteria to guide lateral-flow lipoarabinomannan testing among HIV-positive inpatients a systematic review and individual participant data meta-analysis 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 16 May 2022 9 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Gesehen am 16.08.2022 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. 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 Hamada, Yohhei verfasserin aut Kengne, Andre P. verfasserin aut Kerkhoff, Andrew D. verfasserin aut Broger, Tobias verfasserin (DE-588)1208538853 (DE-627)1694882047 aut Denkinger, Claudia M. 1978- verfasserin (DE-588)131597701 (DE-627)511279469 (DE-576)298613727 aut Rangaka, Molebogeng X. verfasserin aut Gupta-Wright, Ankur verfasserin aut Fielding, Katherine verfasserin aut Wood, Robin verfasserin aut Huerga, Helena verfasserin aut Rücker, Sekai Chenai Mathabire verfasserin aut Bjerrum, Stephanie verfasserin aut Johansen, Isik S. verfasserin aut Thit, Swe Swe verfasserin aut Kyi, Mar Mar verfasserin aut Hanson, Josh verfasserin aut Barr, David A. verfasserin aut Meintjes, Graeme verfasserin aut Maartens, Gary verfasserin aut Enthalten in Journal of infection Amsterdam [u.a.] : Elsevier, 1979 85(2022), 1, Seite 40-48 Online-Ressource (DE-627)320506436 (DE-600)2012883-6 (DE-576)104344717 1532-2742 nnns volume:85 year:2022 number:1 pages:40-48 extent:9 https://doi.org/10.1016/j.jinf.2022.05.010 Verlag Resolving-System lizenzpflichtig Volltext GBV_USEFLAG_U GBV_ILN_2013 ISIL_DE-16-250 SYSFLAG_1 GBV_KXP SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2106 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 85 2022 1 40-48 9 2013 01 DE-16-250 4179783169 00 --%%-- --%%-- --%%-- --%%-- l01 16-08-22 2013 01 DE-16-250 00 s hd2022 2013 01 DE-16-250 01 s (DE-627)1410508463 wissenschaftlicher Artikel (Zeitschrift) 2013 01 DE-16-250 02 s per_20 2013 01 DE-16-250 03 s s_9 2013 01 DE-16-250 04 p (DE-627)1796263966 Broger, Tobias 2013 01 DE-16-250 04 k (DE-627)1416466967 Medizinische Fakultät Heidelberg 2013 01 DE-16-250 04 s (DE-627)1410501914 Verfasser 2013 01 DE-16-250 04 s pos_5 2013 01 DE-16-250 05 p (DE-627)1668020653 Denkinger, Claudia M. 2013 01 DE-16-250 05 k (DE-627)1495544966 Zentrum für Infektiologie 2013 01 DE-16-250 05 k (DE-627)1416466967 Medizinische Fakultät Heidelberg 2013 01 DE-16-250 05 s (DE-627)1410501914 Verfasser 2013 01 DE-16-250 05 s pos_6 |
| spelling |
10.1016/j.jinf.2022.05.010 doi (DE-627)181441620X (DE-599)KXP181441620X (OCoLC)1361706433 DE-627 ger DE-627 rda eng Dhana, Ashar verfasserin (DE-588)1265528349 (DE-627)1814417869 aut Diagnostic accuracy of WHO screening criteria to guide lateral-flow lipoarabinomannan testing among HIV-positive inpatients a systematic review and individual participant data meta-analysis 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 16 May 2022 9 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Gesehen am 16.08.2022 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. 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 Hamada, Yohhei verfasserin aut Kengne, Andre P. verfasserin aut Kerkhoff, Andrew D. verfasserin aut Broger, Tobias verfasserin (DE-588)1208538853 (DE-627)1694882047 aut Denkinger, Claudia M. 1978- verfasserin (DE-588)131597701 (DE-627)511279469 (DE-576)298613727 aut Rangaka, Molebogeng X. verfasserin aut Gupta-Wright, Ankur verfasserin aut Fielding, Katherine verfasserin aut Wood, Robin verfasserin aut Huerga, Helena verfasserin aut Rücker, Sekai Chenai Mathabire verfasserin aut Bjerrum, Stephanie verfasserin aut Johansen, Isik S. verfasserin aut Thit, Swe Swe verfasserin aut Kyi, Mar Mar verfasserin aut Hanson, Josh verfasserin aut Barr, David A. verfasserin aut Meintjes, Graeme verfasserin aut Maartens, Gary verfasserin aut Enthalten in Journal of infection Amsterdam [u.a.] : Elsevier, 1979 85(2022), 1, Seite 40-48 Online-Ressource (DE-627)320506436 (DE-600)2012883-6 (DE-576)104344717 1532-2742 nnns volume:85 year:2022 number:1 pages:40-48 extent:9 https://doi.org/10.1016/j.jinf.2022.05.010 Verlag Resolving-System lizenzpflichtig Volltext GBV_USEFLAG_U GBV_ILN_2013 ISIL_DE-16-250 SYSFLAG_1 GBV_KXP SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2106 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 85 2022 1 40-48 9 2013 01 DE-16-250 4179783169 00 --%%-- --%%-- --%%-- --%%-- l01 16-08-22 2013 01 DE-16-250 00 s hd2022 2013 01 DE-16-250 01 s (DE-627)1410508463 wissenschaftlicher Artikel (Zeitschrift) 2013 01 DE-16-250 02 s per_20 2013 01 DE-16-250 03 s s_9 2013 01 DE-16-250 04 p (DE-627)1796263966 Broger, Tobias 2013 01 DE-16-250 04 k (DE-627)1416466967 Medizinische Fakultät Heidelberg 2013 01 DE-16-250 04 s (DE-627)1410501914 Verfasser 2013 01 DE-16-250 04 s pos_5 2013 01 DE-16-250 05 p (DE-627)1668020653 Denkinger, Claudia M. 2013 01 DE-16-250 05 k (DE-627)1495544966 Zentrum für Infektiologie 2013 01 DE-16-250 05 k (DE-627)1416466967 Medizinische Fakultät Heidelberg 2013 01 DE-16-250 05 s (DE-627)1410501914 Verfasser 2013 01 DE-16-250 05 s pos_6 |
| allfields_unstemmed |
10.1016/j.jinf.2022.05.010 doi (DE-627)181441620X (DE-599)KXP181441620X (OCoLC)1361706433 DE-627 ger DE-627 rda eng Dhana, Ashar verfasserin (DE-588)1265528349 (DE-627)1814417869 aut Diagnostic accuracy of WHO screening criteria to guide lateral-flow lipoarabinomannan testing among HIV-positive inpatients a systematic review and individual participant data meta-analysis 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 16 May 2022 9 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Gesehen am 16.08.2022 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. 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 Hamada, Yohhei verfasserin aut Kengne, Andre P. verfasserin aut Kerkhoff, Andrew D. verfasserin aut Broger, Tobias verfasserin (DE-588)1208538853 (DE-627)1694882047 aut Denkinger, Claudia M. 1978- verfasserin (DE-588)131597701 (DE-627)511279469 (DE-576)298613727 aut Rangaka, Molebogeng X. verfasserin aut Gupta-Wright, Ankur verfasserin aut Fielding, Katherine verfasserin aut Wood, Robin verfasserin aut Huerga, Helena verfasserin aut Rücker, Sekai Chenai Mathabire verfasserin aut Bjerrum, Stephanie verfasserin aut Johansen, Isik S. verfasserin aut Thit, Swe Swe verfasserin aut Kyi, Mar Mar verfasserin aut Hanson, Josh verfasserin aut Barr, David A. verfasserin aut Meintjes, Graeme verfasserin aut Maartens, Gary verfasserin aut Enthalten in Journal of infection Amsterdam [u.a.] : Elsevier, 1979 85(2022), 1, Seite 40-48 Online-Ressource (DE-627)320506436 (DE-600)2012883-6 (DE-576)104344717 1532-2742 nnns volume:85 year:2022 number:1 pages:40-48 extent:9 https://doi.org/10.1016/j.jinf.2022.05.010 Verlag Resolving-System lizenzpflichtig Volltext GBV_USEFLAG_U GBV_ILN_2013 ISIL_DE-16-250 SYSFLAG_1 GBV_KXP SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2106 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 85 2022 1 40-48 9 2013 01 DE-16-250 4179783169 00 --%%-- --%%-- --%%-- --%%-- l01 16-08-22 2013 01 DE-16-250 00 s hd2022 2013 01 DE-16-250 01 s (DE-627)1410508463 wissenschaftlicher Artikel (Zeitschrift) 2013 01 DE-16-250 02 s per_20 2013 01 DE-16-250 03 s s_9 2013 01 DE-16-250 04 p (DE-627)1796263966 Broger, Tobias 2013 01 DE-16-250 04 k (DE-627)1416466967 Medizinische Fakultät Heidelberg 2013 01 DE-16-250 04 s (DE-627)1410501914 Verfasser 2013 01 DE-16-250 04 s pos_5 2013 01 DE-16-250 05 p (DE-627)1668020653 Denkinger, Claudia M. 2013 01 DE-16-250 05 k (DE-627)1495544966 Zentrum für Infektiologie 2013 01 DE-16-250 05 k (DE-627)1416466967 Medizinische Fakultät Heidelberg 2013 01 DE-16-250 05 s (DE-627)1410501914 Verfasser 2013 01 DE-16-250 05 s pos_6 |
| allfieldsGer |
10.1016/j.jinf.2022.05.010 doi (DE-627)181441620X (DE-599)KXP181441620X (OCoLC)1361706433 DE-627 ger DE-627 rda eng Dhana, Ashar verfasserin (DE-588)1265528349 (DE-627)1814417869 aut Diagnostic accuracy of WHO screening criteria to guide lateral-flow lipoarabinomannan testing among HIV-positive inpatients a systematic review and individual participant data meta-analysis 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 16 May 2022 9 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Gesehen am 16.08.2022 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. 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 Hamada, Yohhei verfasserin aut Kengne, Andre P. verfasserin aut Kerkhoff, Andrew D. verfasserin aut Broger, Tobias verfasserin (DE-588)1208538853 (DE-627)1694882047 aut Denkinger, Claudia M. 1978- verfasserin (DE-588)131597701 (DE-627)511279469 (DE-576)298613727 aut Rangaka, Molebogeng X. verfasserin aut Gupta-Wright, Ankur verfasserin aut Fielding, Katherine verfasserin aut Wood, Robin verfasserin aut Huerga, Helena verfasserin aut Rücker, Sekai Chenai Mathabire verfasserin aut Bjerrum, Stephanie verfasserin aut Johansen, Isik S. verfasserin aut Thit, Swe Swe verfasserin aut Kyi, Mar Mar verfasserin aut Hanson, Josh verfasserin aut Barr, David A. verfasserin aut Meintjes, Graeme verfasserin aut Maartens, Gary verfasserin aut Enthalten in Journal of infection Amsterdam [u.a.] : Elsevier, 1979 85(2022), 1, Seite 40-48 Online-Ressource (DE-627)320506436 (DE-600)2012883-6 (DE-576)104344717 1532-2742 nnns volume:85 year:2022 number:1 pages:40-48 extent:9 https://doi.org/10.1016/j.jinf.2022.05.010 Verlag Resolving-System lizenzpflichtig Volltext GBV_USEFLAG_U GBV_ILN_2013 ISIL_DE-16-250 SYSFLAG_1 GBV_KXP SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2106 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 85 2022 1 40-48 9 2013 01 DE-16-250 4179783169 00 --%%-- --%%-- --%%-- --%%-- l01 16-08-22 2013 01 DE-16-250 00 s hd2022 2013 01 DE-16-250 01 s (DE-627)1410508463 wissenschaftlicher Artikel (Zeitschrift) 2013 01 DE-16-250 02 s per_20 2013 01 DE-16-250 03 s s_9 2013 01 DE-16-250 04 p (DE-627)1796263966 Broger, Tobias 2013 01 DE-16-250 04 k (DE-627)1416466967 Medizinische Fakultät Heidelberg 2013 01 DE-16-250 04 s (DE-627)1410501914 Verfasser 2013 01 DE-16-250 04 s pos_5 2013 01 DE-16-250 05 p (DE-627)1668020653 Denkinger, Claudia M. 2013 01 DE-16-250 05 k (DE-627)1495544966 Zentrum für Infektiologie 2013 01 DE-16-250 05 k (DE-627)1416466967 Medizinische Fakultät Heidelberg 2013 01 DE-16-250 05 s (DE-627)1410501914 Verfasser 2013 01 DE-16-250 05 s pos_6 |
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10.1016/j.jinf.2022.05.010 doi (DE-627)181441620X (DE-599)KXP181441620X (OCoLC)1361706433 DE-627 ger DE-627 rda eng Dhana, Ashar verfasserin (DE-588)1265528349 (DE-627)1814417869 aut Diagnostic accuracy of WHO screening criteria to guide lateral-flow lipoarabinomannan testing among HIV-positive inpatients a systematic review and individual participant data meta-analysis 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 16 May 2022 9 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Gesehen am 16.08.2022 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. 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 Hamada, Yohhei verfasserin aut Kengne, Andre P. verfasserin aut Kerkhoff, Andrew D. verfasserin aut Broger, Tobias verfasserin (DE-588)1208538853 (DE-627)1694882047 aut Denkinger, Claudia M. 1978- verfasserin (DE-588)131597701 (DE-627)511279469 (DE-576)298613727 aut Rangaka, Molebogeng X. verfasserin aut Gupta-Wright, Ankur verfasserin aut Fielding, Katherine verfasserin aut Wood, Robin verfasserin aut Huerga, Helena verfasserin aut Rücker, Sekai Chenai Mathabire verfasserin aut Bjerrum, Stephanie verfasserin aut Johansen, Isik S. verfasserin aut Thit, Swe Swe verfasserin aut Kyi, Mar Mar verfasserin aut Hanson, Josh verfasserin aut Barr, David A. verfasserin aut Meintjes, Graeme verfasserin aut Maartens, Gary verfasserin aut Enthalten in Journal of infection Amsterdam [u.a.] : Elsevier, 1979 85(2022), 1, Seite 40-48 Online-Ressource (DE-627)320506436 (DE-600)2012883-6 (DE-576)104344717 1532-2742 nnns volume:85 year:2022 number:1 pages:40-48 extent:9 https://doi.org/10.1016/j.jinf.2022.05.010 Verlag Resolving-System lizenzpflichtig Volltext GBV_USEFLAG_U GBV_ILN_2013 ISIL_DE-16-250 SYSFLAG_1 GBV_KXP SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2106 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 85 2022 1 40-48 9 2013 01 DE-16-250 4179783169 00 --%%-- --%%-- --%%-- --%%-- l01 16-08-22 2013 01 DE-16-250 00 s hd2022 2013 01 DE-16-250 01 s (DE-627)1410508463 wissenschaftlicher Artikel (Zeitschrift) 2013 01 DE-16-250 02 s per_20 2013 01 DE-16-250 03 s s_9 2013 01 DE-16-250 04 p (DE-627)1796263966 Broger, Tobias 2013 01 DE-16-250 04 k (DE-627)1416466967 Medizinische Fakultät Heidelberg 2013 01 DE-16-250 04 s (DE-627)1410501914 Verfasser 2013 01 DE-16-250 04 s pos_5 2013 01 DE-16-250 05 p (DE-627)1668020653 Denkinger, Claudia M. 2013 01 DE-16-250 05 k (DE-627)1495544966 Zentrum für Infektiologie 2013 01 DE-16-250 05 k (DE-627)1416466967 Medizinische Fakultät Heidelberg 2013 01 DE-16-250 05 s (DE-627)1410501914 Verfasser 2013 01 DE-16-250 05 s pos_6 |
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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. 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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%. 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misc Adolescent misc Adult misc Diagnosis misc HIV Infections misc HIV Seropositivity misc Human immunodeficiency virus misc Humans misc Inpatient misc Inpatients misc LAM misc Lipoarabinomannan misc Lipopolysaccharides misc Mycobacterium tuberculosis misc Screening misc Sensitivity misc Sensitivity and Specificity misc Specificity misc Sputum misc Tuberculosis misc World Health Organization 2013 hd2022 2013 wissenschaftlicher Artikel (Zeitschrift) 2013 per_20 2013 s_9 2013 Broger, Tobias 2013 Medizinische Fakultät Heidelberg 2013 Verfasser 2013 pos_5 2013 Denkinger, Claudia M. 2013 Zentrum für Infektiologie 2013 pos_6 |
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Diagnostic accuracy of WHO screening criteria to guide lateral-flow lipoarabinomannan testing among HIV-positive inpatients a systematic review and individual participant data meta-analysis |
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Diagnostic accuracy of WHO screening criteria to guide lateral-flow lipoarabinomannan testing among HIV-positive inpatients a systematic review and individual participant data meta-analysis 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 |
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diagnostic accuracy of who screening criteria to guide lateral-flow lipoarabinomannan testing among hiv-positive inpatientsa systematic review and individual participant data meta-analysis |
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Diagnostic accuracy of WHO screening criteria to guide lateral-flow lipoarabinomannan testing among HIV-positive inpatients a systematic review and individual participant data meta-analysis |
| 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. Gesehen am 16.08.2022 |
| abstractGer |
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. Gesehen am 16.08.2022 |
| abstract_unstemmed |
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. Gesehen am 16.08.2022 |
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