Evaluation of Host Serum Protein Biomarkers of Tuberculosis in sub-Saharan Africa.

摘要: Accurate and affordable point-of-care diagnostics for tuberculosis (TB) are needed. Host serum protein signatures have been derived use in primary care settings, however validation of these secondary settings is lacking. We evaluated biomarkers discovered cohorts from Africa reapplied to patients care. In this nested case-control study, concentrations 22 proteins were quantified sera 292 Malawi South who presented predominantly Recruitment was based upon intention local clinicians test TB. The case definition TB culture positivity Mycobacterium tuberculosis; other diseases (OD) a confirmed alternative diagnosis. Equal numbers OD selected. Within each group, there equal with without HIV site. Patients split into training sets biosignature discovery. A nine-protein signature distinguish comprising fibrinogen, alpha-2-macroglobulin, CRP, MMP-9, transthyretin, complement factor H, IFN-gamma, IP-10, TNF-alpha. This had an area under the receiver operating characteristic curve set 90% (95% CI 86-95%), and, after adjusting cut-off increased sensitivity, sensitivity specificity 92% 80-98%) 71% 56-84%), respectively. best single biomarker H [area 70% 64-76%)]. Biosignatures consisting host may function as screening tests African hospitals. Complement identified new such signatures.