A systematic review of commercial serological antibody detection tests for the diagnosis of extrapulmonary tuberculosis. Issue 985 (7th November 2007)

• Record Type: Journal Article
• Authors: Steingart, Karen R; Henry, Megan; Laal, Suman; Hopewell, Philip C; Ramsay, Andrew; Menzies, Dick; Cunningham, Jane; Weldingh, Karin; Pai, Madhukar
• Is Part Of: Postgraduate medical journal. Volume 83:Issue 985(2007)
• Page Start: 705
• Page End: 712
• Publication Date: 2007-11-07
• Subjects: Medicine -- Periodicals; 610
• DOI: 10.1136/thx.2006.075754
• Languages: English
• ISSNs: 0032-5473

Abstract

Abstract : Conventional diagnostic tests for tuberculosis have several limitations and are often unhelpful in establishing the diagnosis of extrapulmonary tuberculosis. Although commercial serological antibody based tests are available, their usefulness in the diagnosis of extrapulmonary tuberculosis is unknown. A systematic review was conducted to assess the accuracy of commercial serological antibody detection tests for the diagnosis of extrapulmonary tuberculosis. In a comprehensive search, 21 studies that reported data on sensitivity and specificity for extrapulmonary tuberculosis were identified. These studies evaluated seven different commercial tests, with Anda-TB IgG accounting for 48 of the studies. The results showed that 1 all commercial tests provided highly variable estimates of sensitivity range 0.001.00 and specificity range 0.591.00 for all extrapulmonary sites combined; 2 the Anda-TB IgG kit showed highly variable sensitivity range 0.261.00 and specificity range 0.591.00 for all extrapulmonary sites combined; 3 for all tests combined, sensitivity estimates for both lymph node tuberculosis range 0.231.00 and pleural tuberculosis range 0.260.59 were poor and inconsistent; and 4 there were no data to determine the accuracy of the tests in children or in patients with HIV infection, the two groups for which the test would be most useful. At present, commercial antibody detection tests for extrapulmonary tuberculosis have no role in clinical care or case detection.