SETTING: Rapid, simple and inexpensive methods are needed to improve the diagnosis of tuberculosis in low-income countries. The MycoDot test has these characteristics. OBJECTIVE: To assess the utility of the MycoDot test in screening patients with suspected tuberculosis. DESIGN: Ambulatory patients presenting with symptoms of pulmonary tuberculosis were evaluated by physical examination and sputum acid-fast bacilli (AFB) microscopy. Separately, the MycoDot test was performed on whole blood. Patients with AFB-negative smears were treated with a 10-day course of erythromycin. Those remaining symptomatic had a chest radiograph. All sputum specimens were cultured for mycobacteria. Patients with culture-negative tuberculosis and those without a tuberculosis diagnosis were reassessed at 2 months. RESULTS: Among the 241 patients who were evaluated, the MycoDot test was positive in 26% of patients with AFB-positive/culture-positive tuberculosis, 7% with AFB-negative/culture-positive tuberculosis, 7% with culture-negative tuberculosis, 19% treated for tuberculosis who did not meet study case definitions, and 16% without tuberculosis. Twenty four patients did not complete the assessment. Test sensitivity was 16%, specificity 84% and positive predictive value 45%. Sensitivity was highest (41%) in AFB-positive/HIV-negative patients and lowest (3%) in AFB-negative/HIV-positive patients. CONCLUSION: The MycoDot test is not useful for the diagnosis of tuberculosis in sub-Saharan African countries, especially where HIV infection is prevalent.
SETTING: Rapid, simple and inexpensive methods are needed to improve the diagnosis of tuberculosis in low-income countries. The MycoDot test has these characteristics. OBJECTIVE: To assess the utility of the MycoDot test in screening patients with suspected tuberculosis. DESIGN: Ambulatory patients presenting with symptoms of pulmonary tuberculosis were evaluated by physical examination and sputum acid-fast bacilli (AFB) microscopy. Separately, the MycoDot test was performed on whole blood. Patients with AFB-negative smears were treated with a 10-day course of erythromycin. Those remaining symptomatic had a chest radiograph. All sputum specimens were cultured for mycobacteria. Patients with culture-negative tuberculosis and those without a tuberculosis diagnosis were reassessed at 2 months. RESULTS: Among the 241 patients who were evaluated, the MycoDot test was positive in 26% of patients with AFB-positive/culture-positive tuberculosis, 7% with AFB-negative/culture-positive tuberculosis, 7% with culture-negative tuberculosis, 19% treated for tuberculosis who did not meet study case definitions, and 16% without tuberculosis. Twenty four patients did not complete the assessment. Test sensitivity was 16%, specificity 84% and positive predictive value 45%. Sensitivity was highest (41%) in AFB-positive/HIV-negative patients and lowest (3%) in AFB-negative/HIV-positive patients. CONCLUSION: The MycoDot test is not useful for the diagnosis of tuberculosis in sub-Saharan African countries, especially where HIV infection is prevalent.
Authors: Celine Gounder; Fernanda Carvalho De Queiroz Mello; Marcus B Conde; William R Bishai; Afrânio L Kritski; Richard E Chaisson; Susan E Dorman Journal: J Clin Microbiol Date: 2002-06 Impact factor: 5.948
Authors: David A J Moore; Carlton A W Evans; Robert H Gilman; Luz Caviedes; Jorge Coronel; Aldo Vivar; Eduardo Sanchez; Yvette Piñedo; Juan Carlos Saravia; Cayo Salazar; Richard Oberhelman; Maria-Graciela Hollm-Delgado; Doris LaChira; A Roderick Escombe; Jon S Friedland Journal: N Engl J Med Date: 2006-10-12 Impact factor: 91.245
Authors: Karen R Steingart; Laura L Flores; Nandini Dendukuri; Ian Schiller; Suman Laal; Andrew Ramsay; Philip C Hopewell; Madhukar Pai Journal: PLoS Med Date: 2011-08-09 Impact factor: 11.069
Authors: Antonia M I Saktiawati; Ymkje Stienstra; Yanri W Subronto; Ning Rintiswati; Jan-Willem Gerritsen; Henny Oord; Onno W Akkerman; Tjip S van der Werf Journal: PLoS One Date: 2019-06-13 Impact factor: 3.240
Authors: Karen R Steingart; Megan Henry; Suman Laal; Philip C Hopewell; Andrew Ramsay; Dick Menzies; Jane Cunningham; Karin Weldingh; Madhukar Pai Journal: PLoS Med Date: 2007-06 Impact factor: 11.069