摘要
Background and Objective: Tuberculosis is one of the leading causes of morbi-mortality, especially in developing countries, due to delayed diagnosis and management. The goal of this study is to assess the contribution of lipoarabinomannan (LAM) in improving tuberculosis (TB) diagnosis in the Central African Republic (C.A.R.). Methods: We conducted a retrospective study at the Regional University Hospital of Bria. The records of patients hospitalized, tested by Determine<sup>®</sup> TB LAM Ag (Alere, Medical Co, LTD, Chiba, Japan) immunochromatographic test for the detection of LAM in urine, associated or not with acid-fast bacilli (AFB) research by Ziehl-Neelsen stain, were selected from August to October 2020. Results: During this study, 152 files were selected. Among them, there were 50.0% of children aged 14 or less (≤14 years: 33.6% + 16.4%) and 50.0% of adults represented. Patients living in the displaced person camp represented a larger group (65.1%) than those in the other 2 sites. There were seventy-four patients (i.e. 48.7%) who did not benefit from screening for AFB. For the other seventy-eight (i.e. 51.3%), there were 17.1% positive results for the search of AFB. However, among the 152 patients, there was a positive HIV serology in 30.9% of cases (i.e. 47 out of 152) and a positive Determine<sup>®</sup> TB LAM Ag in 38.2% of cases (i.e. 58 out of 152). It appears that Determine<sup>®</sup> TB LAM Ag was significantly more able to diagnose tuberculosis than AFB (p 0.003). The 58 patients diagnosed with TB LAM included 20 children who could not provide sputum and HIV-infected patients (p 0.03). Conclusion: The results of this study showed that the microscopy for AFB made it possible to make the diagnosis of tuberculosis in 17.1% of patients against 38.2% for the Alere Determine<sup>®</sup> TB LAM Ag test. This result highlights the need for routine use of LAM detection to improve the diagnosis of tuberculosis. The conduct of a subsequent study combining Xpert MTB/RIF would improve the diagnosis of tuberculosis using all 3 tests.
Background and Objective: Tuberculosis is one of the leading causes of morbi-mortality, especially in developing countries, due to delayed diagnosis and management. The goal of this study is to assess the contribution of lipoarabinomannan (LAM) in improving tuberculosis (TB) diagnosis in the Central African Republic (C.A.R.). Methods: We conducted a retrospective study at the Regional University Hospital of Bria. The records of patients hospitalized, tested by Determine<sup>®</sup> TB LAM Ag (Alere, Medical Co, LTD, Chiba, Japan) immunochromatographic test for the detection of LAM in urine, associated or not with acid-fast bacilli (AFB) research by Ziehl-Neelsen stain, were selected from August to October 2020. Results: During this study, 152 files were selected. Among them, there were 50.0% of children aged 14 or less (≤14 years: 33.6% + 16.4%) and 50.0% of adults represented. Patients living in the displaced person camp represented a larger group (65.1%) than those in the other 2 sites. There were seventy-four patients (i.e. 48.7%) who did not benefit from screening for AFB. For the other seventy-eight (i.e. 51.3%), there were 17.1% positive results for the search of AFB. However, among the 152 patients, there was a positive HIV serology in 30.9% of cases (i.e. 47 out of 152) and a positive Determine<sup>®</sup> TB LAM Ag in 38.2% of cases (i.e. 58 out of 152). It appears that Determine<sup>®</sup> TB LAM Ag was significantly more able to diagnose tuberculosis than AFB (p 0.003). The 58 patients diagnosed with TB LAM included 20 children who could not provide sputum and HIV-infected patients (p 0.03). Conclusion: The results of this study showed that the microscopy for AFB made it possible to make the diagnosis of tuberculosis in 17.1% of patients against 38.2% for the Alere Determine<sup>®</sup> TB LAM Ag test. This result highlights the need for routine use of LAM detection to improve the diagnosis of tuberculosis. The conduct of a subsequent study combining Xpert MTB/RIF would improve the diagnosis of tuberculosis using all 3 tests.
作者
Christian Diamant Mossoro-Kpinde
Honorat Nouzoukem
Marcel Mbeko Simaleko
Nina Esther Ngoyi Ontsira
Hermione Dahlia Mossoro-Kpinde
Irenee Galendji
Henri Diemer
Gérard Grésenguet
Christian Diamant Mossoro-Kpinde;Honorat Nouzoukem;Marcel Mbeko Simaleko;Nina Esther Ngoyi Ontsira;Hermione Dahlia Mossoro-Kpinde;Irenee Galendji;Henri Diemer;Gérard Grésenguet(University Hospital Center Mother Elisabeth Domitien, Bimbo, Central African Republic;National Laboratory of Clinical Biology and Public Health, Bangui, Central African Republic;Department of Biomedical Sciences, Health Sciences Faculty, Bangui, Central African Republic;Public Health Department, Health Sciences Faculty, Bangui, Central African Republic;Bacteriology and Virology Laboratory, University Hospital Center of Brazzaville, Brazzaville, Republic of the Congo;Faculty of Sciences, Marien Ngouabi University, Brazzaville, Republic of the Congo;Regional University Hospital of Bria, Bria, Central African Republic)
