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Early morning urine collection to improve the sensitivity of LAM in hospitalised TB/HIV co-infected patients

Point-of-care detection of urine lipoarabinomannan (LAM) is a low-cost rapid TB diagnostic for use in HIV co-infected patients. However, its sensitivity in these patients is suboptimal. Strategies to improve its performance is a need. The hypothesis was that early morning urine (EMU), rather than ra...

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Main Author: Gina, Ntombenhle Phindile
Other Authors: Dheda, Keertan
Format: Thesis
Language:English
Published: Division of Pulmonology 2016
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access_status_str Open Access
author Gina, Ntombenhle Phindile
author2 Dheda, Keertan
author_browse Dheda, Keertan
Gina, Ntombenhle Phindile
author_facet Dheda, Keertan
Gina, Ntombenhle Phindile
author_sort Gina, Ntombenhle Phindile
collection Thesis
description Point-of-care detection of urine lipoarabinomannan (LAM) is a low-cost rapid TB diagnostic for use in HIV co-infected patients. However, its sensitivity in these patients is suboptimal. Strategies to improve its performance is a need. The hypothesis was that early morning urine (EMU), rather than random urine sampling, would improve LAM's sensitivity. Methods Recruitment process conducted between June 2012 and February 2014 for HIV-infected patients from four hospitals in Cape Town, South Africa presenting with possible TB (all patients initiated on TB treatment). Fresh random and early morning urine (EMU) samples (~10-30 ml) collected in sterile containers. Following the manufacturer's instructions, an Alere Determine® TB Lateral flow assay performed on each sample, using both grade 1 and 2 cut-points. A single sputum Xpert MTB/RIF and/or liquid TB culture was a reference standard. Those designated probable TB patients were sputum Xpert MTB/RIF and/ TB culture negative, but started on TB treatment.
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language eng
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provenance_str_mv Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository
publishDate 2016
publishDateRange 2016
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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:11427/20834 Early morning urine collection to improve the sensitivity of LAM in hospitalised TB/HIV co-infected patients Gina, Ntombenhle Phindile Dheda, Keertan Peter, Jonathan G Randall, Philippa Internal Medicine Point-of-care detection of urine lipoarabinomannan (LAM) is a low-cost rapid TB diagnostic for use in HIV co-infected patients. However, its sensitivity in these patients is suboptimal. Strategies to improve its performance is a need. The hypothesis was that early morning urine (EMU), rather than random urine sampling, would improve LAM's sensitivity. Methods Recruitment process conducted between June 2012 and February 2014 for HIV-infected patients from four hospitals in Cape Town, South Africa presenting with possible TB (all patients initiated on TB treatment). Fresh random and early morning urine (EMU) samples (~10-30 ml) collected in sterile containers. Following the manufacturer's instructions, an Alere Determine® TB Lateral flow assay performed on each sample, using both grade 1 and 2 cut-points. A single sputum Xpert MTB/RIF and/or liquid TB culture was a reference standard. Those designated probable TB patients were sputum Xpert MTB/RIF and/ TB culture negative, but started on TB treatment. 2016-07-27T10:13:35Z 2016-07-27T10:13:35Z 2016 Master Thesis Masters MMed http://hdl.handle.net/11427/20834 eng application/pdf Division of Pulmonology Faculty of Health Sciences University of Cape Town
spellingShingle Internal Medicine
Gina, Ntombenhle Phindile
Early morning urine collection to improve the sensitivity of LAM in hospitalised TB/HIV co-infected patients
thesis_degree_str Master's
title Early morning urine collection to improve the sensitivity of LAM in hospitalised TB/HIV co-infected patients
title_full Early morning urine collection to improve the sensitivity of LAM in hospitalised TB/HIV co-infected patients
title_fullStr Early morning urine collection to improve the sensitivity of LAM in hospitalised TB/HIV co-infected patients
title_full_unstemmed Early morning urine collection to improve the sensitivity of LAM in hospitalised TB/HIV co-infected patients
title_short Early morning urine collection to improve the sensitivity of LAM in hospitalised TB/HIV co-infected patients
title_sort early morning urine collection to improve the sensitivity of lam in hospitalised tb hiv co infected patients
topic Internal Medicine
url http://hdl.handle.net/11427/20834
work_keys_str_mv AT ginantombenhlephindile earlymorningurinecollectiontoimprovethesensitivityoflaminhospitalisedtbhivcoinfectedpatients