TB LAMP assay, a beneficial tool for the diagnosis of Tubercular meningitis in resource-limited settings

Introduction: Tubercular meningitis (TBM) is a serious public health problem in developing countries as it leads to significant mortality and residual neurological sequelae. The estimated mortality due to TBM in India is 1.5 per 100,000 population. In resource-limited settings, only the Ziehl-Neels...

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Main Authors: Vineeta Mittal, Manoj Kumar, Ajay Kumar Singh
Format: Article
Language:English
Published: The Journal of Infection in Developing Countries 2024-03-01
Series:Journal of Infection in Developing Countries
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Online Access:https://jidc.org/index.php/journal/article/view/18115
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author Vineeta Mittal
Manoj Kumar
Ajay Kumar Singh
author_facet Vineeta Mittal
Manoj Kumar
Ajay Kumar Singh
author_sort Vineeta Mittal
collection DOAJ
description Introduction: Tubercular meningitis (TBM) is a serious public health problem in developing countries as it leads to significant mortality and residual neurological sequelae. The estimated mortality due to TBM in India is 1.5 per 100,000 population. In resource-limited settings, only the Ziehl-Neelsen (ZN) stain, which has very little sensitivity, is available. The World Health Organization recommended the Loop Mediated Isothermal Amplification (TB LAMP) assay for pulmonary tuberculosis only. We evaluated this test for tubercular meningitis as well. Methodology: In a cross-sectional study of 2-year duration, we have taken 239 cerebrospinal fluid samples from suspected cases of tubercular meningitis patients. ZN staining along with Mycobacteria Growth Indicator Tube (MGIT) TB culture, Xpert MTB/RIF Ultra assay, and commercial TB LAMP assay were performed for each sample. Results: Out of 239 samples, 40 samples (16.73%) were found TB LAMP assay positive, 48 samples (20.08%) were found Xpert ultra-assay positive, 12 samples (5.02%) were MGIT TB culture positive and acid-fast bacillus smear positive in ten samples (4.18 %). Out of 12 MGIT-positive samples, all samples (100%) were TB LAMP and Xpert ultra positive and one sample (8.33%) was ZN smear positive. In 199 negative samples from the TB LAMP assay, eight samples were positive by Xpert, none by MGIT TB culture and AFB smear. Sensitivity and specificity were found as 100% and 87.66%, respectively, for the TB LAMP assay. Conclusion: TB LAMP assay is a rapid, cost-effective, sensitive, and specific test for tubercular meningitis infection in resource-limited settings.
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spelling doaj-art-01d586d72fa64851a6ff36a82b78fe512025-08-20T02:14:20ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802024-03-01180310.3855/jidc.18115TB LAMP assay, a beneficial tool for the diagnosis of Tubercular meningitis in resource-limited settingsVineeta Mittal0Manoj Kumar1Ajay Kumar Singh2Department of Microbiology, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, IndiaDepartment of Microbiology, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, IndiaDepartment of Neurology, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, India Introduction: Tubercular meningitis (TBM) is a serious public health problem in developing countries as it leads to significant mortality and residual neurological sequelae. The estimated mortality due to TBM in India is 1.5 per 100,000 population. In resource-limited settings, only the Ziehl-Neelsen (ZN) stain, which has very little sensitivity, is available. The World Health Organization recommended the Loop Mediated Isothermal Amplification (TB LAMP) assay for pulmonary tuberculosis only. We evaluated this test for tubercular meningitis as well. Methodology: In a cross-sectional study of 2-year duration, we have taken 239 cerebrospinal fluid samples from suspected cases of tubercular meningitis patients. ZN staining along with Mycobacteria Growth Indicator Tube (MGIT) TB culture, Xpert MTB/RIF Ultra assay, and commercial TB LAMP assay were performed for each sample. Results: Out of 239 samples, 40 samples (16.73%) were found TB LAMP assay positive, 48 samples (20.08%) were found Xpert ultra-assay positive, 12 samples (5.02%) were MGIT TB culture positive and acid-fast bacillus smear positive in ten samples (4.18 %). Out of 12 MGIT-positive samples, all samples (100%) were TB LAMP and Xpert ultra positive and one sample (8.33%) was ZN smear positive. In 199 negative samples from the TB LAMP assay, eight samples were positive by Xpert, none by MGIT TB culture and AFB smear. Sensitivity and specificity were found as 100% and 87.66%, respectively, for the TB LAMP assay. Conclusion: TB LAMP assay is a rapid, cost-effective, sensitive, and specific test for tubercular meningitis infection in resource-limited settings. https://jidc.org/index.php/journal/article/view/18115CSFTB LAMPMGITTBMXpertZN Smear
spellingShingle Vineeta Mittal
Manoj Kumar
Ajay Kumar Singh
TB LAMP assay, a beneficial tool for the diagnosis of Tubercular meningitis in resource-limited settings
Journal of Infection in Developing Countries
CSF
TB LAMP
MGIT
TBM
Xpert
ZN Smear
title TB LAMP assay, a beneficial tool for the diagnosis of Tubercular meningitis in resource-limited settings
title_full TB LAMP assay, a beneficial tool for the diagnosis of Tubercular meningitis in resource-limited settings
title_fullStr TB LAMP assay, a beneficial tool for the diagnosis of Tubercular meningitis in resource-limited settings
title_full_unstemmed TB LAMP assay, a beneficial tool for the diagnosis of Tubercular meningitis in resource-limited settings
title_short TB LAMP assay, a beneficial tool for the diagnosis of Tubercular meningitis in resource-limited settings
title_sort tb lamp assay a beneficial tool for the diagnosis of tubercular meningitis in resource limited settings
topic CSF
TB LAMP
MGIT
TBM
Xpert
ZN Smear
url https://jidc.org/index.php/journal/article/view/18115
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AT manojkumar tblampassayabeneficialtoolforthediagnosisoftubercularmeningitisinresourcelimitedsettings
AT ajaykumarsingh tblampassayabeneficialtoolforthediagnosisoftubercularmeningitisinresourcelimitedsettings