ArticleIJTLD open2026
Lateral-flow urine lipoarabinomannan for TB diagnosis in children.
Article in IJTLD open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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9 authors.
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Abstract
backgroundDiagnosing childhood TB is challenging due to nonspecific symptoms and difficulty obtaining sputum samples. This study evaluated the urine-based Alere Determine™ TB-LAM Ag test (AlereLAM) in a high-burden TB, HIV, and malnutrition setting.
methodsMédecins Sans Frontières conducted a cross-sectional study in Malakal, South Sudan (October 2021-November 2023). Children (6 months-15 years) with presumptive TB received clinical and laboratory tests, including Xpert-Ultra and AlereLAM, regardless of HIV status. TB was classified as confirmed (Xpert-Ultra positive), unconfirmed (clinical), or unlikely.
resultsOf the 276 children (median age: 44 months), 53.3% (147/276) were female, 64.9% (179/276) were severely malnourished, and 9.4% (26/276) were children living with HIV. TB was confirmed in 10.5% (29/276), unconfirmed in 50.7% (140/276), and unlikely in 38.8% (169/276). Overall, AlereLAM positivity was 17.8% (49/276), with higher positivity in confirmed TB (27.6%; 8/29) than unconfirmed (20.0%; 28/140) and unlikely TB (12.1%; 13/107). Using confirmed plus unconfirmed TB as positive and unlikely TB as negative reference standard, sensitivity was 21.3% (95% confidence interval [CI]: 15.4-28.3), specificity 87.9% (95% CI: 80.1-93.4), positive predictive value (PPV) 73.5% (95% CI: 58.9-85.1), and negative predictive value 41.4% (95% CI: 34.9-48.1).
conclusionAlereLAM's high specificity and PPV support ruling in TB in resource-limited settings, but low sensitivity highlights the need for additional diagnostic tests.
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