{"title":"Urinary lipoarabinomannan for diagnosis of Tuberculosis in an HIV-negative population: A scoping review.","authors":"Omishka Hirachund, Somasundram Pillay","doi":"10.4102/phcfm.v16i1.4733","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong> Tuberculosis (TB) remains a leading cause of mortality in low-resource settings and poses a diagnostic challenge in human immunodeficiency virus (HIV)-negative populations because of limitations in traditional diagnostic methods such as sputum smear microscopy (SSM) and sputum Xpert Ultra. There is a lack of effective, non-invasive diagnostic options for TB diagnosis in HIV-negative populations. This scoping review explores the potential of urinary lipoarabinomannan (ULAM) as a point-of-care diagnostic tool for Mycobacterium tuberculosis (MTB) in HIV-negative individuals.</p><p><strong>Aim: </strong> To evaluate the diagnostic performance of ULAM in detecting TB among HIV-negative populations and assess its feasibility as a rapid, non-invasive diagnostic method.</p><p><strong>Method: </strong> A systematic search was conducted across PubMed, Google Scholar and Scopus. Articles were selected based on relevance to the topic.</p><p><strong>Results: </strong> The search yielded 210 articles, with 11 meeting our inclusion criteria. These studies reported varying diagnostic performance metrics for ULAM: sensitivity ranged from 10.0% to 66.7% and specificity from 90.0% to 98.1% among different assays. Notably, the studies demonstrated that the novel assays such as Electrochemiluminescence LAM and the second-generation FujiLAM showed higher sensitivities of 66.7% and 53.2%, respectively. Despite these advancements, the overall effectiveness of ULAM in HIV-negative populations remains limited, with standard assays exhibiting sensitivities as low as 10.0%.</p><p><strong>Conclusion: </strong> While ULAM holds potential as a diagnostic tool in HIV-associated TB, its application in HIV-negative populations is constrained by low sensitivity of the currently available assays.Contribution: The development and validation of high-sensitivity assays are crucial for broadening the utility of ULAM in these populations.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"16 1","pages":"e1-e6"},"PeriodicalIF":1.2000,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"African Journal of Primary Health Care & Family Medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4102/phcfm.v16i1.4733","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"PRIMARY HEALTH CARE","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Tuberculosis (TB) remains a leading cause of mortality in low-resource settings and poses a diagnostic challenge in human immunodeficiency virus (HIV)-negative populations because of limitations in traditional diagnostic methods such as sputum smear microscopy (SSM) and sputum Xpert Ultra. There is a lack of effective, non-invasive diagnostic options for TB diagnosis in HIV-negative populations. This scoping review explores the potential of urinary lipoarabinomannan (ULAM) as a point-of-care diagnostic tool for Mycobacterium tuberculosis (MTB) in HIV-negative individuals.
Aim: To evaluate the diagnostic performance of ULAM in detecting TB among HIV-negative populations and assess its feasibility as a rapid, non-invasive diagnostic method.
Method: A systematic search was conducted across PubMed, Google Scholar and Scopus. Articles were selected based on relevance to the topic.
Results: The search yielded 210 articles, with 11 meeting our inclusion criteria. These studies reported varying diagnostic performance metrics for ULAM: sensitivity ranged from 10.0% to 66.7% and specificity from 90.0% to 98.1% among different assays. Notably, the studies demonstrated that the novel assays such as Electrochemiluminescence LAM and the second-generation FujiLAM showed higher sensitivities of 66.7% and 53.2%, respectively. Despite these advancements, the overall effectiveness of ULAM in HIV-negative populations remains limited, with standard assays exhibiting sensitivities as low as 10.0%.
Conclusion: While ULAM holds potential as a diagnostic tool in HIV-associated TB, its application in HIV-negative populations is constrained by low sensitivity of the currently available assays.Contribution: The development and validation of high-sensitivity assays are crucial for broadening the utility of ULAM in these populations.