Feasibility of using Determine TB-LAM to diagnose tuberculosis in HIV-positive patients in programmatic conditions: a multisite study.

Mathabire Rucker SC Cossa L Harrison RE Mpunga J Lobo S Kisaka Kimupelenge P Mandar Kol'Ampwe F Amoros Quiles I Molfino L Szumilin E Telnov O Ndlovu Z Huerga H
Global health action 2019 ; 12(1); 1672366. doi: 10.1080/16549716.2019.1672366. Epub 2019 10 15
Lipoarabinomannan diagnosis implementation low income settings tuberculosis

Abstract

: Determine TB-LAM is a urine-based point-of-care assay for diagnosis of tuberculosis (TB). : To assess the feasibility of using LAM to diagnose TB in adult HIV-positive patients in resource-limited settings. : We performed a multi-centric mixed-methods cross-sectional descriptive study in the Democratic Republic of Congo, Malawi, and Mozambique. We used the study and program monitoring tools to estimate user workload, turn-around time (TAT), and proportion of patients with LAM and sputum-based results. We conducted semi-structured interviews to assess the user acceptability of the LAM. : The duration of the LAM testing activity per patient was 27 min (IQR 26-29); staff continued with other duties whilst waiting for the result. More patients had a LAM versus a sputum-based result: 168/213 (78.9%) vs 77/213 (36.1%), p