Table 2 Utility of Determine TB-LAM point-of-care assay when used in combination with other diagnostic tests for HIV-associated tuberculosis (TB)
Combination of diagnostic tests | Advantages |
|---|---|
Sputum smear microscopy + Determine TB-LAM | · Incremental sensitivity. |
|  | · Smear microscopy diagnoses most infectious patients |
|  | · Determine TB-LAM provides rapid point-of-care diagnosis in those with high mortality risk permitting immediate initiation of TB treatment. |
|  | · Low-cost. |
Chest radiology + Determine TB-LAM | · Determine TB-LAM can provide rapid point-of-care assessment of patients with abnormal chest radiographs, increasing the specificity for TB diagnosis. |
|  | · Small incremental cost to radiology. |
Sputum culture + Determine TB-LAM | · Determine TB-LAM greatly expedites TB diagnosis in the sickest patients with highest mortality risk. |
|  | · Small incremental cost to culture. |
Sputum Xpert MTB/RIF + Determine TB-LAM | · Determine TB-LAM adds little diagnostic sensitivity when used with Xpert MTB/RIF, but provides rapid point-of-care assessment. When Xpert is located in laboratories precluding same-day testing, Determine TB-LAM will expedite TB treatment in those with highest mortality risk, allowing immediate initiation of TB treatment. |
|  | · Small incremental cost to Xpert MTB/RIF. |