Status of enzyme-linked immunosorbent assay test for tuberculosis serology in low socio economic status and undernourished children with suspected pulmonary tuberculosis

Authors

  • Kripasindhu Chatterjee Department of Pediatrics, ICARE Institute of Medical Sciences and Research, Haldia, West Bengal
  • Pradyut Kumar Mandal Department of Pediatrics, ICARE Institute of Medical Sciences and Research, Haldia, West Bengal
  • Nabamita Chaudhuri Department of Microbiology, KPC Medical College, Kolkata, West Bengal
  • Satarupa Mukherjee Department of Pediatrics, ICARE Institute of Medical Sciences and Research, Haldia, West Bengal
  • Nabendu Chaudhuri Department of Pediatrics, ICARE Institute of Medical Sciences and Research, Haldia, West Bengal
  • Sukanta Sen Department of Pharmacology, ICARE Institute of Medical Sciences and Research, Haldia, West Bengal

DOI:

https://doi.org/10.18203/2349-3291.ijcp20163675

Keywords:

ELISA test, Low socio-economic status, Tuberculosis, Undernourished children

Abstract

Background:Tuberculosis (TB) continues to be a major health problem in developing countries like India. The diagnosis of childhood tuberculosis is very difficult, because of paucibacillary nature of childhood disease and the confirmation is the detection of Mycobacterium Tuberculosis from sputum and similar specimen i.e. lymph node or other body fluid. The other means of diagnosis determination of antibody of tubercular IgM/IgA/IgG by enzyme-linked immunosorbent assay (ELISA). Once it was considered a very good one but subsequent analysis is not so specific. The sensitivity and specificity was not good. Thus the ELISA has been discarded by WHO in 2011. The sensitivity and specificity was done all the patients’ irrespective age, nutritional and socioeconomic status. The objective of the study was to know its exact status of tubercular antibodies in low socioeconomic status.

Methods: The present study was conducted on 115 children who were suffering from clinically suspected pulmonary tuberculosis (PT) and those who had enlarged cervical lymph nodes as extra pulmonary tuberculosis (EPT). For all the cases MT test was done. The ELISA serological test of IgM and IgG antibodies were done.

Results:The present study has documented that the sensitivity and specificity is much lower than the studies conducted by the other authors conducted in different types of population of different age groups.

Conclusions:The ELISA serological tests of antibodies have false positivity and negativity. This leads over diagnosis or under diagnosis of tuberculosis. It is strongly recommended that these commercial tests not be used for the diagnosis of pulmonary and extra-pulmonary TB.  

Metrics

Metrics Loading ...

References

Newton SM, Brent AJ, Anderson S, Whittaker E, Kampmann B. Paediatric tuberculosis. Lancet Infect Dis. 2008;8(8):498-510.

Daniel TM, Debanne SM. The serodiagnosis of tuberculosis and other mycobacterial diseases by enzyme-linked immunosorbent assay. Am Rev Respir Dis. 1987;135(5):1137-51.

Wilkins EG, Ivanyi J. Potential value of serology for diagnosis of extrapulmonary tuberculosis. Lancet. 1990;336(8716):641-4.

Pottumarthy S, Wells VC, Morris AJ. A comparison of seven tests for serological diagnosis of tuberculosis. J Clin Microbiol. 2000;38(6):2227-31.

Steingart KR, Ramsay A, Dowdy DW, Pai M. Serological tests for diagnosis of active tuberculosis: relevance for India. Indian J Med Res. 2012;135:695-702.

Grenier J, Pinto L, Nair D, Steingart K, Dowdy D, Ramsay A, Pai M. Widespread use of serological tests for tuberculosis: data from 22 high-burden countries. Eur Respir J. 2012;39(2):502-5.

The scandal of TB diagnosis tropical disease research to foster evolution and knowledge application 2010. Available at http://www.fropikanet/svc/news/20101113/chinnock-20101113-news-TB India. Accessed on 22 March 2016.

Morris K. WHO recommendation against inaccurate tuberculosis test. Lancet. 2011;337:113-4.

World Health Organisation on behalf of the special program for research and training in tropical diseases. Laboratory based evaluation of 19 commercially available rapid diagnostic tests of tuberculosis: 2008 Geneva: World Health Organisation. Available at http:// www.who.int /tdr/publication/documents/diagnostic–evaluation2. Pdf. Accessed on 29 March 2016.

Unni CG. Mycobacterial infection. IAP Drug Formulary: Published as IAP Action Plan. 2009:70-3.

Bothamley GH. Serological diagnosis of tuberculosis. Eur Respir J. 1995;8(20):676-688.

Commercial serodiagnostic tests for diagnosis of tuberculosis. Available at: http:// www. tbevidence. org/documents/policies/WHO%20Policy%20Statement%20on%20Commercial%20TB%20Serodiagnostic%20Tests%202011.pdf. Accessed on 22 June 2016.

Dowdy DW, Steingart KR, Pai M. Serological testing versus other strategies for diagnosis of active tuberculosis in India: a cost effective analysis PLOSMed. 2011;8:1001074.

Nayak S, Acharjya B. Mantoux test and its interpretation. Indian Dermatol Online J. 2012;3(1):2-6.

Gevaudan MJ, Bollet C, Charpin D, Mallet MN, Micco P. Serological response of tuberculosis patients to antigen 60 of BCG. Eur J Epidemiol. 1992;8(5):666-76.

Banerjee S, Gupta S, Shende N, Kumar S, Harinath BC. Serodiagnosis of tuberculosis using two ELISA systems. Indian J Clin Biochem. 2003;18(2):48-53.

Nair ER, Banerjee S, Kumar S, Reddy MVR, Harinath BC. Purification and characterization of a 31 kDa mycobacterial excretory-secretory antigenic protein with a diagnostic potential in pulmonary tuberculosis. Ind J Chest Dis Allied Sci. 2001;43:81-90.

Beyers N, Gie RP, Schaaf HS. A prospective evaluation of children under the age of 5 years living in the same household as adults with recently diagnosed pulmonary tuberculosis. Int J Tuberc Lung Dis. 1997;1(1):38-43.

Jacobs RF, Starke JR. Tuberculosis in children. Med Clin North Am. 1993;77(6):1335-51.

WHO. A research agenda for childhood tuberculosis. Geneva: World Health Organisation; 2007.

Marais BJ, Pai M. Recent advances in the diagnosis of childhood tuberculosis. Arch Dis Child. 2007;92(5):446-52.

Zar HJ, Hanslo D, Apolles P, Swingler G, Hussey G. Induced sputum versus gastric lavage for microbiological confirmation of pulmonary tuberculosis in infants and young children: a prospective study. Lancet. 2005;365(9454):130-4.

Lawson L, Yassin MA, Ramsay A, Emenyonu NE, Squire SB, Cuevas LE. Comparison of scanty AFB smear against culture in an area with high HIV prevalence. Int J Tubre Lung Dis. 2005;9:933-5.

Elliott AM, Namaambok, Allen BW. Negative sputum smear results in HIV positive patients with pulmonary tuberculosis patients in Luska, Zambia. Tuber Lung Dis. 1993;74:191-4.

Granier T, Pinto L, Nair D, Steingart K, Dowdy, Ramsay A, et al. Widespread use of serological tests for Tuberculosis: data from 22 high burden countries. Eur Respir J. 2012;39;502-5.

Specter M. A deadly misdiagnosis. The New Yorker. New York; 2010:48-53.

Gennaro ML. Immunologic diagnosis of tuberculosis. Clin Infect Dis. 2000;30(3):243-6.

Laal S, Skeiky YAW. Immune based methods. In: Cole STEK, Mcmurray DN, Jacobs WR. Tuberculosis and the tubercle bacillus. Washington, DC: ASM Press;2005:71-83.

Boehme C, Molokova E, Minja F. Detection of mycobacterial lipoarabinomannan with an antigen-capture ELISA in unprocessed urine of Tanzanian patients with suspected tuberculosis. Trans R Soc Trop Med Hyg. 2005;99(12):893-900.

Steingart KR, Henry M, Laal S. A systematic review of commercial serological antibody detection tests for the diagnosis of extra pulmonary tuberculosis. Thorax. 2007;62(10):911-8.

Kapoor VK. Abdominal tuberculosis. Postgrad Med J. 1998;74:459-67.

Steingart KR, Henry M, Laal S, Hopewell PC, Ramsay A, Menzies D, et al. Commercial serological antibody detection tests for diagnosis of Pulmonary Tuberculosis. Health Technol. 2007;11:196-8.

Leeflong MM, Deeks JJ, Gatsonis C, Bossyut PM. Cochrane dignostic test accuracy working grou, systemic reviews of diagnostic test accuracy. Ann Intern Med. 2008;149:887-97.

Department of Human culture in an area with high HIV prevalence. Centres for disease control and prevention, reported tuberculosis in the United States 2006, Atlanta, GA;US. Int J Tubre Lung Dis. 2005;9:933.

Guyatt GH, Oxman AD, Visit GE, Kunz R, Falck YY, Alonso CP, et al. GRADE working group: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ. 2008;336:924.

Directorate general of health service. Advisory against commercial serological tests. Central TB Division, Ministry of Health and Family Welfare. New Delhi. 2011.

Working group on tuberculosis. Indian Academy of Pediatrics. Consensus statement on childhood tuberculosis. Indian Pediatr. 2010;47:41-5.

World Health Organisation: Global Tuberculosis Control: WHO Report 2011. Available at http://www.who.inf/tb/publication/global_report/2011/gtbr11_full_pdf. Accessed on 21 March 2016.

Downloads

Published

2016-12-22

How to Cite

Chatterjee, K., Mandal, P. K., Chaudhuri, N., Mukherjee, S., Chaudhuri, N., & Sen, S. (2016). Status of enzyme-linked immunosorbent assay test for tuberculosis serology in low socio economic status and undernourished children with suspected pulmonary tuberculosis. International Journal of Contemporary Pediatrics, 3(4), 1348–1354. https://doi.org/10.18203/2349-3291.ijcp20163675

Issue

Section

Original Research Articles