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Table 1 Studies reporting urinary LAM detection and mortality included in the systematic review

From: Detection of lipoarabinomannan (LAM) in urine is an independent predictor of mortality risk in patients receiving treatment for HIV-associated tuberculosis in sub-Saharan Africa: a systematic review and meta-analysis

Study

LAM assay used (type of urine sample)

Study setting and population (country)

Median CD4 cell count (by LAM status if presented) (cells/μl)

Number of TB cases/total number in study (prevalence %)

Number of urinary LAM-positive TB cases (%)

Duration of follow-up (months)

Overall mortality in TB cases (%)

Number of TB deaths/number of TB cases (%)

RR of mortalitya

(95 % CI)

Quality assessment scoreb

LAM positive

LAM negative

Shah et al. (2009)

[47]

Clearview TB ELISA (frozen urine)

Hospitalised patients; TB suspected (South Africa)

79

193/499 (38.7)

114 (59.1)

2

22.3

31/114 (27.2)

12/79 (15.2)

1.8 (1.0–3.3)

60

Lawn et al. (2012)

[48]

Determine TB-LAM lateral flow assay (frozen urine)

Outpatient clinic; patients initiating ART (South Africa)

100 (LAM-positive 37; LAM-negative 115)

59/325 (18.2)

23 (39.0)

3

8.5

5/23 (21.7)

0/36 (0.0)

NA

70

Talbot et al. (2012) [49]

Clearview TB ELISA (fresh and frozen urine)

Hospitalised patients; TB suspected (Tanzania)

86

69/212 (32.5)

45 (65.2)

2

52.9

25/38 (65.8)

33/83 (39.8)

1.7 (1.2–2.3)

75

Peter et al. (2013)

[50]

Determine TB-LAM lateral flow assay (frozen urine)

Hospitalised patients; TB suspected (South Africa)

89 (LAM-positive 62; LAM-negative 180)

116/281 (4.2)

58 (50.0)

2

13.9

6/25 (24.0)c

1/23 (8.5)c

5.5 (0.7–42.4)

80

Balcha et al. (2014) [51]

Determine TB-LAM lateral flow assay (frozen urine)

Outpatient clinic; ART naïve; sputum producers (Ethiopia)

176 (LAM-positive 94; LAM-negative 187)

128/757 (16.9)

35 (27.3)

6

6.8

7/35 (20.0)

3/113 (2.7)

7.5 (2.1–27.6)

60

Manabe et al. (2014) [28]

Determine TB-LAM lateral flow assay (fresh urine)

Hospitalised patients; TB suspects (Uganda)

57

145/351 (41.3)

90 (62.1)

2

22.1

25/90 (27.8)

7/37 (12.7)

2.2 (1.0–4.7)

75

Drain et al. (2015)

[52]

Determine TB-LAM lateral flow assay (frozen urine)

Outpatient clinic; patients initiating TB treatment (South Africa)

168 (LAM-positive 106; LAM-negative 198)

90/90 (100.0)

29 (22.2)

36

27.8

9/29 (31.0)

16/61 (26.2)

1.2 (0.6–2.4)

70

Peter et al. (2015)

[53]

Determine TB-LAM lateral flow assay (frozen urine)

Hospitalised patients; TB suspected (South Africa)

210

181/583 (31.0)

41 (22.7)

6

13.0

6/17 (35.2)

15/106 (14.2)

2.5 (1.1–5.5)

85

Lawn et al. (2015)

[54]

Determine TB-LAM lateral flow assay (frozen urine)

Hospitalised patients; all HIV+ patients (South Africa)

148

136/427 (31.2)

53 (39.0)

3

13.7

13/5 (24.5)

6/83 (7.2)

3.4 (1.4–8.4)

75

Bjerrum et al. (2015) [55]

Determine TB-LAM lateral flow assay (fresh urine)

Hospital inpatient and outpatient; TB suspected (Ghana)

127

55/469 (11.7)

24 (43.6)

6

32.7

13/24 (54.2)

5/31 (16.1)

3.4 (1.4–8.1)

70

  1. ART antiretroviral therapy, CI confidence interval, ELISA enzyme-linked immunosorbent assay, LAM lipoarabinomannan, NA not applicable, RR relative risk, TB tuberculosis. aUrinary LAM-positive TB cases compared to urinary LAM-negative TB cases. bQuality assessment score graded as follows: (<50 poor, 50–74 moderate, >74 good. cMortality in TB cases with urinary LAM results only reported in patients who did not receive ‘early empirical TB therapy’
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BMC Medicine

ISSN: 1741-7015

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