C-Reactive Protein Testing for Active Tuberculosis among Inpatients without HIV in Uganda: a Diagnostic Accuracy Study
Amanda Meyer, Emmanuel Ochom, Patricia Turimumahoro, Patrick Byanyima, Ingvar Sanyu, Rejani Lalitha, Sylvia Kaswabuli, Alfred Andama, Nicholas D. Walter, Achilles Katamba, Adithya Cattamanchi, William Worodria, Laurence Huang, Christina Yoon, J. Lucian Davis
Abstract
culture, CRP had a sensitivity of 78% (95% confidence interval [CI], 64 to 89%) and a specificity of 52% (95% CI, 40 to 64%) at the manufacturer's threshold of 10 mg/liter. At a threshold of 1.5 mg/liter, the sensitivity was 91% (95% CI, 79 to 98%) but the specificity was only 21% (95% CI, 12 to 32%). Performance did not differ when stratified by illness severity at either threshold. In conclusion, among HIV-seronegative inpatients, CRP testing performed substantially below targets for a TB triage test. Additional studies among HIV-seronegative individuals in clinics and community settings are needed to assess the utility of CRP for TB screening.