kaolinite and Tuberculosis--Pulmonary

The global tuberculosis epidemic results in nearly 2 million deaths and 9 million new cases of the disease a year. The vast majority of tuberculosis patients live in developing countries, where the diagnosis of tuberculosis relies on the identification of acid-fast bacilli on unprocessed sputum smears using conventional light microscopy. Microscopy has high specificity in tuberculosis-endemic countries, but modest sensitivity which varies among laboratories (range 20% to 80%). Moreover, the sensitivity is poor for paucibacillary disease (e.g., pediatric and HIV-associated tuberculosis). Thus, the development of rapid and accurate new diagnostic tools is imperative. Immune-based tests are potentially suitable for use in low-income countries as some test formats can be performed at the point of care without laboratory equipment. Currently, dozens of distinct commercial antibody detection tests are sold in developing countries. The question is "do they work?". We conducted a systematic review to assess the accuracy of commercial antibody detection tests for the diagnosis of pulmonary tuberculosis. Studies from all countries using culture and/or microscopy smear for confirmation of pulmonary tuberculosis were eligible. Studies with fewer than 50 participants (25 patients and 25 control participants) were excluded. In a comprehensive search, we identified 68 studies. The results demonstrate that (1) overall, commercial tests vary widely in performance; (2) sensitivity is higher in smear-positive than smear-negative samples; (3) in studies of smear-positive patients, Anda-TB IgG by enzyme-linked immunosorbent assay shows limited sensitivity (range 63% to 85%) and inconsistent specificity (range 73% to 100%); (4) specificity is higher in healthy volunteers than in patients in whom tuberculosis disease is initially suspected and subsequently ruled out; and (5) there are insufficient data to determine the accuracy of most commercial tests in smear microscopy-negative patients, as well as their performance in children or persons with HIV infection.. None of the commercial tests evaluated perform well enough to replace sputum smear microscopy. Thus, these tests have little or no role in the diagnosis of pulmonary tuberculosis. Lack of methodological rigor in these studies was identified as a concern. It will be important to review the basic science literature evaluating serological tests for the diagnosis of pulmonary tuberculosis to determine whether useful antigens have been described but their potential has not been fully exploited. Activities leading to the discovery of new antigens with immunodiagnostic potential need to be intensified.

Topics: Adult; Agglutination Tests; Antibodies, Bacterial; Blood Preservation; Blotting, Western; Child; Comorbidity; Developing Countries; Enzyme-Linked Immunosorbent Assay; HIV Infections; Humans; Immunoglobulin G; Kaolin; Mycobacterium tuberculosis; Predictive Value of Tests; Reagent Kits, Diagnostic; Reproducibility of Results; Research Design; Sensitivity and Specificity; Sputum; Tuberculosis, Pulmonary

Kaolin agglutination test (KAT), for the detection of anti-tuberculophospholipid antibodies for the serodiagnosis of tuberculosis, was performed on the sera of 137 pulmonary and 276 extra pulmonary tuberculosis patients and 140 controls. The sensitivity and specificity of KAT was 86.9% and 100%, respectively, at the titre of 1:128 and more.

Topics: Agglutination Tests; Antibodies, Antiphospholipid; Antibodies, Bacterial; Double-Blind Method; Humans; Kaolin; Mycobacterium tuberculosis; Sensitivity and Specificity; Tuberculosis; Tuberculosis, Pulmonary

The article represents features for differential diagnosis between pulmonary tuberculosis and dust diseases in workers engaged into mullite refractories production. The author suggests possible course of the disease as a new type of chronic pulmonary malady--mullitosis.

Topics: Aluminum Compounds; Catchment Area, Health; Chronic Disease; Humans; Industry; Kaolin; Lung Diseases; Mineral Fibers; Occupational Diseases; Russia; Tuberculosis, Pulmonary

Topics: Adult; Aged; Antigens, Bacterial; Hemagglutination Tests; Humans; Kaolin; Middle Aged; Mycobacterium tuberculosis; Phospholipids; Tuberculosis, Pulmonary

Topics: Adolescent; Adult; Age Factors; Agglutination Tests; Antibodies, Bacterial; Blood Donors; Female; Humans; Kaolin; Male; Middle Aged; Phospholipids; Sex Factors; Syphilis; Tuberculosis, Pulmonary

Topics: Complement Fixation Tests; Humans; Kaolin; Serologic Tests; Tuberculosis, Pulmonary

Topics: Adult; Animals; Culture Media; Guinea Pigs; Humans; Injections; Kaolin; Lung; Middle Aged; Mycobacterium tuberculosis; Pneumoconiosis; Silicon Dioxide; Statistics as Topic; Talc; Time Factors; Tuberculosis, Pulmonary

Topics: Adolescent; Agglutination Tests; Antibodies; Humans; Kaolin; Latex Fixation Tests; Male; Phospholipids; Tuberculosis, Pulmonary

Topics: Adolescent; Adult; Animals; BCG Vaccine; Cattle; Child; Female; Guinea Pigs; Hemagglutination Tests; Humans; Kaolin; Kenya; Male; Tuberculin Test; Tuberculosis, Bovine; Tuberculosis, Pulmonary

Topics: Adolescent; Adult; Aged; Agglutination Tests; BCG Vaccine; Child; Child, Preschool; Female; Gastrointestinal Diseases; Humans; Hypersensitivity, Delayed; Infant; Kaolin; Male; Middle Aged; Neoplasms; Tuberculin Test; Tuberculosis, Pulmonary

Topics: Adolescent; Adult; Aged; Agglutination Tests; Black or African American; Black People; Child; Child, Preschool; Drug Resistance, Microbial; Female; Humans; Infant; Infant, Newborn; Isoniazid; Kaolin; Kenya; Male; Middle Aged; Radiography; Sputum; Tuberculin Test; Tuberculosis, Pulmonary

Topics: Agglutination Tests; Follow-Up Studies; Humans; Kaolin; Tuberculosis, Pulmonary

Topics: Bronchial Neoplasms; Dust; Humans; Kaolin; Lung; Pneumoconiosis; Prevalence; Radiography, Thoracic; Silicosis; Tuberculosis; Tuberculosis, Pulmonary

Topics: Kaolin; Serologic Tests; Temperature; Tuberculosis; Tuberculosis, Pulmonary; Water

Topics: Complement Fixation Tests; Complement System Proteins; Humans; Kaolin; Tuberculosis; Tuberculosis, Pulmonary

Topics: Agglutination; Hemagglutination; Hemagglutination Tests; Humans; Kaolin; Mycobacterium tuberculosis; Phospholipids; Tuberculosis; Tuberculosis, Pulmonary

Topics: Animals; Bacillus; Coal; Dust; Guinea Pigs; Kaolin; Lung; Mining; Mycobacterium bovis; Pneumoconiosis; Rats; Tuberculosis; Tuberculosis, Pulmonary

Topics: Kaolin; Pleural Cavity; Pleurisy; Pneumothorax; Pneumothorax, Artificial; Tuberculosis; Tuberculosis, Pulmonary