MPT64 antigen detection test improves diagnosis of pediatric extrapulmonary tuberculosis in Mbeya, Tanzania
Abstract Pediatric extrapulmonary tuberculosis (EPTB) is a diagnostic challenge. A new immunochemistry based MPT64 antigen detection test has shown improved sensitivity compared to current laboratory tests. The aim of this study was to implement and validate the test performance in a resource limite...
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2021
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oai:doaj.org-article:3fa65131173241629370dd43c7efb9792021-12-02T16:38:49ZMPT64 antigen detection test improves diagnosis of pediatric extrapulmonary tuberculosis in Mbeya, Tanzania10.1038/s41598-021-97010-22045-2322https://doaj.org/article/3fa65131173241629370dd43c7efb9792021-09-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-97010-2https://doaj.org/toc/2045-2322Abstract Pediatric extrapulmonary tuberculosis (EPTB) is a diagnostic challenge. A new immunochemistry based MPT64 antigen detection test has shown improved sensitivity compared to current laboratory tests. The aim of this study was to implement and validate the test performance in a resource limited African setting. Presumptive pediatric (0–18 y) EPTB patients were prospectively enrolled at Mbeya Zonal Referral Hospital, and followed to the end of treatment or until a final diagnosis was reached. Specimens from suspected sites of infection were subject to routine diagnostics, GeneXpert MTB/RIF assay and the MPT64 test. The performance of the tests was assessed using mycobacterial culture as well as a composite reference standard. 30 patients were categorized as TB cases, 31 as non-TB cases and 2 were uncategorized. In the TB group, the three most common infections were adenitis (30%), peritonitis (30%) and meningitis (20%). The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of the MPT64 test was 92%, 88%, 87%, 92% and 90%, respectively. Mortality was equally high among TB/non-TB cases (23% vs 21%), and malnutrition was the main comorbidity among TB cases. The MPT64 test was implementable in the routine diagnostics in a low-resource setting and improved the diagnosis of pediatric EPTB.Erlend GrønningenMarywinnie NanyaroLisbet SvilandEsther NgadayaWilliam MullerLisete TorresSayoki MfinangaTehmina MustafaNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-11 (2021) |
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Medicine R Science Q Erlend Grønningen Marywinnie Nanyaro Lisbet Sviland Esther Ngadaya William Muller Lisete Torres Sayoki Mfinanga Tehmina Mustafa MPT64 antigen detection test improves diagnosis of pediatric extrapulmonary tuberculosis in Mbeya, Tanzania |
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Abstract Pediatric extrapulmonary tuberculosis (EPTB) is a diagnostic challenge. A new immunochemistry based MPT64 antigen detection test has shown improved sensitivity compared to current laboratory tests. The aim of this study was to implement and validate the test performance in a resource limited African setting. Presumptive pediatric (0–18 y) EPTB patients were prospectively enrolled at Mbeya Zonal Referral Hospital, and followed to the end of treatment or until a final diagnosis was reached. Specimens from suspected sites of infection were subject to routine diagnostics, GeneXpert MTB/RIF assay and the MPT64 test. The performance of the tests was assessed using mycobacterial culture as well as a composite reference standard. 30 patients were categorized as TB cases, 31 as non-TB cases and 2 were uncategorized. In the TB group, the three most common infections were adenitis (30%), peritonitis (30%) and meningitis (20%). The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of the MPT64 test was 92%, 88%, 87%, 92% and 90%, respectively. Mortality was equally high among TB/non-TB cases (23% vs 21%), and malnutrition was the main comorbidity among TB cases. The MPT64 test was implementable in the routine diagnostics in a low-resource setting and improved the diagnosis of pediatric EPTB. |
format |
article |
author |
Erlend Grønningen Marywinnie Nanyaro Lisbet Sviland Esther Ngadaya William Muller Lisete Torres Sayoki Mfinanga Tehmina Mustafa |
author_facet |
Erlend Grønningen Marywinnie Nanyaro Lisbet Sviland Esther Ngadaya William Muller Lisete Torres Sayoki Mfinanga Tehmina Mustafa |
author_sort |
Erlend Grønningen |
title |
MPT64 antigen detection test improves diagnosis of pediatric extrapulmonary tuberculosis in Mbeya, Tanzania |
title_short |
MPT64 antigen detection test improves diagnosis of pediatric extrapulmonary tuberculosis in Mbeya, Tanzania |
title_full |
MPT64 antigen detection test improves diagnosis of pediatric extrapulmonary tuberculosis in Mbeya, Tanzania |
title_fullStr |
MPT64 antigen detection test improves diagnosis of pediatric extrapulmonary tuberculosis in Mbeya, Tanzania |
title_full_unstemmed |
MPT64 antigen detection test improves diagnosis of pediatric extrapulmonary tuberculosis in Mbeya, Tanzania |
title_sort |
mpt64 antigen detection test improves diagnosis of pediatric extrapulmonary tuberculosis in mbeya, tanzania |
publisher |
Nature Portfolio |
publishDate |
2021 |
url |
https://doaj.org/article/3fa65131173241629370dd43c7efb979 |
work_keys_str_mv |
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