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Extra-pulmonary samples were obtained from all presumptive EPTB cases and tested for Mycobacterium tuberculosis complex using fluorescent microscopy, Xpert MTB/RIF, and culture. The overall sensitivity and specificity of Xpert MTB/RIF were 43. 2% and 100%, respectively, with the highest sensitivity for Lymph node aspirate and lower sensitivity for pleural fluid and 100% specificity for both specimen types relative to the composite reference standard. With the highest sensitivity for HIV co-infected participants, the sensitivity and specificity of TB-LAM were 33. 3% and 94 percent respectively, with the highest sensitivity for HIV co-infected participants. Despite HIV status, the sensitivity of the combination of Xpert MTB/RIF and TB-LAM tests revealed 61. 9%, although the sensitivity was raised to 83 percent in HIV-positive cases. Conclusion: TB-LAM alone has poor sensitivity to EPTB diagnosis; however, the combination of TB-LAM and Xpert MTB/RIF improves EPTB diagnosis in countries with high EPTB and HIV prevalence, particularly in countries with high EPTB and HIV rates.
Source link: https://doi.org/10.1371/journal.pone.0263172
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