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Novel and newer nucleic acid amplification tests for the diagnosis of TB

Background: Current tools for TB diagnosis have suboptimal accuracy, perform poorly in diagnosing extra-pulmonary TB, and are not point of care; hence results have a slow turn-around time. Objective: This project evaluated the diagnostic accuracy of the promising novel loop mediated isothermal ampl...

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Main Author: Matinyenya, Brian
Other Authors: Dheda, Keertan
Format: Thesis
Language:English
Published: Division of Pulmonology 2016
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access_status_str Open Access
author Matinyenya, Brian
author2 Dheda, Keertan
author_browse Dheda, Keertan
Matinyenya, Brian
author_facet Dheda, Keertan
Matinyenya, Brian
author_sort Matinyenya, Brian
collection Thesis
description Background: Current tools for TB diagnosis have suboptimal accuracy, perform poorly in diagnosing extra-pulmonary TB, and are not point of care; hence results have a slow turn-around time. Objective: This project evaluated the diagnostic accuracy of the promising novel loop mediated isothermal amplification (LAMP) assay on sputum, and that of the semi-automated Xpert MTB/RIF (Xpert) test on non-sputum specimens (bronchoalveolar lavage fluid [BALF], tracheal aspirates, and cerebrospinal fluid [CSF]) from South African patients with suspected TB (the accuracy of Xpert using these fluids was unknown at the time this work was performed). Methodology: Biological samples (sputum, tracheal aspirates, BALF, or CSF) were collected from patients with suspected TB. Liquid culture served as the reference standard for the diagnosis of definite TB. Accuracy was evaluated according to HIV and smear microscopy status, where appropriate. The relationship between test performance and bacterial load (culture time-to-positivity [TTP]) was also compared. For the evaluation of LAMP, 2 spot sputa of approximately 4 ml were collected from 301 patients (60 μl of sputum was used for the assay). For the evaluation of Xpert on BALF, 152 patients who were sputum scarce or smear-negative were recruited (1 ml of the BALF aliquot or a re-suspended pellet from 10 ml BALF was used). For the evaluation of Xpert on tracheal aspirates, 120 tracheal aspirates from patients enrolled in the intensive care unit (ICU) were tested. For the evaluation of Xpert on CSF, 235 patients with suspected TBM had a lumbar puncture with 1 ml of CSF or where available a re-suspended pellet from 3 ml of CSF evaluated using Xpert.
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institution University of Cape Town (South Africa)
language eng
last_indexed 2026-06-10T12:34:25.395Z
license_str Not specified — see source repository
provenance_str_mv Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository
publishDate 2016
publishDateRange 2016
publishDateSort 2016
publisher Division of Pulmonology
publisherStr Division of Pulmonology
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source_str UCTD — University of Cape Town Open Access Repository
spelling oai:open.uct.ac.za:11427/20680 Novel and newer nucleic acid amplification tests for the diagnosis of TB Matinyenya, Brian Dheda, Keertan Theron, Grant Pulmonology Background: Current tools for TB diagnosis have suboptimal accuracy, perform poorly in diagnosing extra-pulmonary TB, and are not point of care; hence results have a slow turn-around time. Objective: This project evaluated the diagnostic accuracy of the promising novel loop mediated isothermal amplification (LAMP) assay on sputum, and that of the semi-automated Xpert MTB/RIF (Xpert) test on non-sputum specimens (bronchoalveolar lavage fluid [BALF], tracheal aspirates, and cerebrospinal fluid [CSF]) from South African patients with suspected TB (the accuracy of Xpert using these fluids was unknown at the time this work was performed). Methodology: Biological samples (sputum, tracheal aspirates, BALF, or CSF) were collected from patients with suspected TB. Liquid culture served as the reference standard for the diagnosis of definite TB. Accuracy was evaluated according to HIV and smear microscopy status, where appropriate. The relationship between test performance and bacterial load (culture time-to-positivity [TTP]) was also compared. For the evaluation of LAMP, 2 spot sputa of approximately 4 ml were collected from 301 patients (60 μl of sputum was used for the assay). For the evaluation of Xpert on BALF, 152 patients who were sputum scarce or smear-negative were recruited (1 ml of the BALF aliquot or a re-suspended pellet from 10 ml BALF was used). For the evaluation of Xpert on tracheal aspirates, 120 tracheal aspirates from patients enrolled in the intensive care unit (ICU) were tested. For the evaluation of Xpert on CSF, 235 patients with suspected TBM had a lumbar puncture with 1 ml of CSF or where available a re-suspended pellet from 3 ml of CSF evaluated using Xpert. 2016-07-25T11:25:25Z 2016-07-25T11:25:25Z 2016 Master Thesis Masters MSc (Med) http://hdl.handle.net/11427/20680 eng application/pdf Division of Pulmonology Faculty of Health Sciences University of Cape Town
spellingShingle Pulmonology
Matinyenya, Brian
Novel and newer nucleic acid amplification tests for the diagnosis of TB
thesis_degree_str Master's
title Novel and newer nucleic acid amplification tests for the diagnosis of TB
title_full Novel and newer nucleic acid amplification tests for the diagnosis of TB
title_fullStr Novel and newer nucleic acid amplification tests for the diagnosis of TB
title_full_unstemmed Novel and newer nucleic acid amplification tests for the diagnosis of TB
title_short Novel and newer nucleic acid amplification tests for the diagnosis of TB
title_sort novel and newer nucleic acid amplification tests for the diagnosis of tb
topic Pulmonology
url http://hdl.handle.net/11427/20680
work_keys_str_mv AT matinyenyabrian novelandnewernucleicacidamplificationtestsforthediagnosisoftb