The Efficiency of TB LAM Antigen Test to Xpert MTB/RIF Ultra Test for the Diagnosis of Tuberculous Pericarditis Using Pericardial Fluid Samples

Author:

Alomatu Samuel1ORCID,Vasaikar Sandeep2ORCID,Thomas Kandathil1,Dubula Thozama3,Moeketsi Khulile1

Affiliation:

1. Cardiology Unit, Department of Internal Medicine, Nelson Mandela Central Hospital, Walter Sisulu University, Mthatha 5117, South Africa

2. Department of Microbiology, Faculty of Health Sciences, Walter Sisulu University, Mthatha 5100, South Africa

3. Office of Dean, Faculty of Health Sciences, Walter Sisulu University, Mthatha 5117, South Africa

Abstract

Medical considerations for early diagnosis of tuberculous pericarditis (TBP) include Xpert MTB/RIF Ultra and TB lipoarabinomannan (LAM) antigen (Ag) tests, with immunological status influencing the performance of the latter. An evaluation of the efficiency of Xpert MTB/RIF Ultra and TB LAM Ag in detecting TBP was conducted using pericardial fluid samples from 46 patients with suspected TBP. Fifteen patients (34.1%) were diagnosed with TBP according to culture results. TB LAM Ag’s sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (PLR), and negative likelihood ratio (NLR) were 33.3%, 100%, 100%, 74.4%, 0, and 0.67, respectively. The sensitivity, specificity, PLR, NLR, PPV, and NPV of Xpert MTB/RIF Ultra were 80%, 93.1%, 11.6, 0.21, 85.7%, and 90%, respectively. There was an association observed between a positive TB LAM Ag test and HIV status. When compared to the Xpert MTB/RIF Ultra test, TB LAM Ag has lower accuracy for the detection of microbiologically proven tuberculous pericarditis, yet its usage in HIV-positive populations may be worth exploring. The TB LAM Ag assay is not the best first-line test for the diagnosis of tuberculous pericarditis, and it should be used in conjunction with other diagnostic tests.

Funder

WSU Internal Medicine Department. Department Research Fund, Walter Sisulu University

Publisher

MDPI AG

Subject

Infectious Diseases,Microbiology (medical),General Immunology and Microbiology,Molecular Biology,Immunology and Allergy

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5. United Nations Development Programme (2015). Sustainable Development Agenda-Sustainable Development Goals by 2030. Goal 3: Good Health and Well-Being, United Nations Development Programme.

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