02240nas a2200385 4500000000100000008004100001260001300042653001500055653001000070653000900080653002400089653002500113653003800138653001100176653001100187653001100198653002100209653001400230653000900244653001600253653002600269653003200295653002800327100001600355700001600371700001500387700001500402700001300417700001400430245010500444300001100549490000600560520127400566022001401840 2005 d c2005 Oct10aAdolescent10aAdult10aAged10aAntigens, Bacterial10aCase-Control Studies10aEnzyme-Linked Immunosorbent Assay10aFemale10aGambia10aHumans10aImmunoglobulin G10aIncidence10aMale10aMiddle Aged10aMultivariate Analysis10aSensitivity and Specificity10aTuberculosis, Pulmonary1 aGreenaway C1 aLienhardt C1 aAdegbola R1 aBrusasca P1 aMcAdam K1 aMenzies D00aHumoral response to Mycobacterium tuberculosis antigens in patients with tuberculosis in the Gambia. a1112-90 v93 a

OBJECTIVE: To determine and compare the sensitivity and specificity of four common mycobacterial antigens with three RD-1 region antigens in the serological diagnosis of active pulmonary tuberculosis (PTB) in the Gambia.

DESIGN: Serum from 300 Gambians (100 with active PTB, 100 of their household contacts, and 100 community controls) was tested using an ELISA method to detect antibodies to seven mycobacterial antigens (three encoded in the RD-1 region [ESAT-6, CFP-10 and Rv3871] and four common [38 kDa, GLU-S, 19 kDa and 14 kDa]). Individuals with active TB were recruited from one of the National Leprosy and TB Control Program clinics in the western region of the Gambia, and neighborhood controls were an age-matched individual living within five houses of the case.

RESULTS: The sensitivity of the RD-1 antigens ranged from 34% to 67%, while specificity ranged from 51% to 71%. The sensitivity of the common antigens ranged from 24% to 75% and specificity from 26% to 75%.

CONCLUSION: In countries with high rates of TB, such as the Gambia, the clinical utility of serological testing to diagnose active TB remains limited, even with newer antigens encoded in the RD-1 region of Mycobacterium tuberculosis.

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