@article{fdi:010066932,
  title = {{D}iagnostic accuracy of the small membrane filtration method for diagnosis of pulmonary tuberculosis in a high-{HIV}-prevalence setting},
  author = {{B}oum, {Y}. and {K}im, {S}. and {O}rikiriza, {P}. and {A}cuna-{V}illaorduna, {C}. and {V}inhas, {S}. and {B}onnet, {M}aryline and {N}yehangane, {D}. and {M}wanga-{A}mumpaire, {J}. and {F}ennelly, {K}. {P}. and {J}ones-{L}opez, {E}. {C}.},
  editor = {},
  language = {{ENG}},
  abstract = {{S}putum acid-fast bacilli ({AFB}) smear microscopy has suboptimal sensitivity but remains the most commonly used laboratory test to diagnose pulmonary tuberculosis ({TB}). {W}e prospectively evaluated the small membrane filtration ({SMF}) method that concentrates {AFB} in a smaller area to facilitate detection to improve the diagnostic performance of microscopy. {W}e enrolled adults with suspicion of pulmonary {TB} from health facilities in southwestern {U}ganda. {C}linical history, physical examination, and 3 sputum samples were obtained for direct fluorescent {AFB} smear, {SMF}, {X}pert {MTB}/{RIF}, and {MGIT} culture media. {S}ensitivity and specificity were estimated for {SMF}, {AFB} smear, and {X}pert {MTB}/{RIF}, using {MGIT} as the reference standard. {T}he analysis was stratified according to {HIV} status. {F}rom {S}eptember 2012 to {A}pril 2014, 737 participants were included in the {HIV}-infected stratum (146 [20.5%] were culture positive) and 313 were in the {HIV}-uninfected stratum (85 [28%] were culture positive). {I}n {HIV}-infected patients, the sensitivity of a single {SMF} was 67.4% (95% confidence interval [{CI}], 59.9% to 74.1%); for {AFB}, 68.0% (95% {CI}, 60.6% to 74.6%); and for {X}pert {MTB}/{RIF}, 91.0% (95% {CI}, 85.0% to 94.8%). {I}n {HIV}-uninfected patients, the corresponding sensitivities were 72.5% (95% {CI}, 62.1% to 80.9%), 80.3% (95% {CI}, 70.8% to 87.2%), and 93.5% (95% {CI}, 85.7% to 97.2%). {T}he specificity for all 3 tests in both {HIV} groups was >= 96%. {I}n this setting, the {SMF} method did not improve the diagnostic accuracy of sputum {AFB}. {T}he {X}pert {MTB}/{RIF} assay performed well in both {HIV}-infected and -uninfected groups.},
  keywords = {{OUGANDA}},
  booktitle = {},
  journal = {{J}ournal of {C}linical {M}icrobiology},
  volume = {54},
  numero = {6},
  pages = {1520--1527},
  ISSN = {0095-1137},
  year = {2016},
  DOI = {10.1128/jcm.00017-16},
  URL = {https://www.documentation.ird.fr/hor/fdi:010066932},
}