TABLE 3.
Diagnostic utility of novel diagnostics for the detection of TB among patients with HIV-associated anaemia; (a) sensitivity among patients with culture-confirmed TB (b) PPV and NPV among the overall cohort (c) specificity among patients without culture confirmed TB
| a) | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| TB Prevalence % (95% CI) | Sputum microscopy | Sputum Xpert x1 | LAM | LAM+sputum microscopy | LAM+ SputumXpert | ||||||
| TB patients | Number | Sensitivity (95% CI) | Number | Sensitivity (95% CI) | Number | Sensitivity (95% CI) | Number | Sensitivity (95% CI) | Number | Sensitivity (95% CI) | |
| Overall (n=81) | - | 24 | 30 (20–41) | 47 | 58 (47–69) | 23 | 28 (19–39) | 36 | 44 (33–56) | 50 | 61 (50–72) |
| No anaemia or mild anaemia (n=39) | - | 6 | 15 (6–31) | 16 | 41 (26–58) | 0 | 0 (0–9) | 6 | 15 (6–31) | 16 | 41 (25–57) |
| Moderate or severe anaemia (n=42) | - | 18 | 43 (28–59) | 31 | 74 (58–86) | 23 | 55 (39–70) | 30 | 71 (55–84) | 34 | 81 (66–91) |
| P-value1 | - | - | 0.007 | - | 0.003 | - | <0.001 | - | <0.001 | - | <0.001 |
| b) | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall cohort | TB Prevalence % (95% CI) | Sputum microscopy | Sputum Xpert x1 | LAM | LAM+sputum microscopy | LAM+ SputumXpert | |||||
| PPV (95% CI) | NPV (95% CI) | PPV (95% CI) | NPV (95% CI) | PPV (95% CI) | NPV (95% CI) | PPV (95% CI) | NPV (95% CI) | PPV (95% CI) | NPV (95% CI) | ||
| Overall (n=485) | 17 (13–20) | 96 (78–100) | 88 (84–90) | 92 (80–98) | 92 (89–94) | 79 (60–91) | 87 (84–90) | 83.7 (69–93) | 90 (87–92) | 83 (71–91) | 93 (90–95) |
| No anaemia or mild anaemia (n=337) | 12 (8–15) | 100 (52–100) | 90 (86–93) | 84 (60–96) | 93 (89–95) | 0 (0–60) | 88 (84–91) | 60 (27–86) | 90 (86–93) | 70 (47–86) | 93 (89–95) |
| Moderate or severe anaemia (n=148) | 28 (21–36) | 95 (72–100) | 81.4 (73.4–87.5) | 97 (82–100) | 91 (83–95) | 92 (72–98) | 85 (77–90) | 91 (75–98) | 90 (82–94) | 92 (77–98) | 93 (86–97) |
| c) | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| TB Prevalence % (95% CI) | Sputum microscopy | Sputum Xpert x1 | LAM | LAM+sputum microscopy | LAM+ SputumXpert | ||||||
| Number | Specificity (95% CI) | Number | Specificity (95% CI) | Number | Specificity (95% CI) | Number | Specificity (95% CI) | Number | Specificity (95% CI) | ||
| Overall (n=404) | - | 403 | 100 (98–100) | 400 | 99 (97–100) | 398 | 99 (97–99) | 403 | 100 (98–100) | 400 | 99 (97–100) |
| No anaemia or mild anemia (n=298) | - | 298 | 100 (99–100) | 295 | 99 (97–100) | 294 | 99 (97–100) | 294 | 99 (97–100) | 291 | 98 (95–99) |
| Moderate or severe anaemia (n=106) | - | 105 | 99 (95–100) | 105 | 99 (95–100) | 104 | 98 (93–100) | 103 | 97 (92–99) | 103 | 97 (92–99) |
1
P value for comparison of sensitivity of diagnostic assays in those with no anaemia/mild anaemia versus those with moderate/severe anaemia.