{"_buckets": {"deposit": "29723fcb-c66e-4444-9396-221611e76cee"}, "_deposit": {"created_by": 100, "id": "7886", "owner": "100", "owners": [100], "owners_ext": {"displayname": "hlahlawin", "username": "hlahlawin"}, "pid": {"revision_id": 0, "type": "depid", "value": "7886"}, "status": "published"}, "_oai": {"id": "oai:meral.edu.mm:recid/00007886", "sets": ["user-um2"]}, "communities": ["um2"], "item_1583103067471": {"attribute_name": "Title", "attribute_value_mlt": [{"subitem_1551255647225": "The clinical utility of the urine-basedlateral flow lipoarabinomannan assayin HIV-infected adults in Myanmar:an observational study", "subitem_1551255648112": "en"}]}, "item_1583103085720": {"attribute_name": "Description", "attribute_value_mlt": [{"interim": "Background:The use of the point-of-care lateral flow lipoarabinomannan (LF-LAM) test may expedite tuberculosis(TB) diagnosis in HIV-positive patients. However, the test’s clinical utility is poorly defined outside sub-Saharan Africa.Methods:The study enrolled consecutive HIV-positive adults at a tertiary referral hospital in Yangon, Myanmar. Onenrolment, patients had a LF-LAM test performed according to the manufacturer’s instructions. Clinicians managingthe patients were unaware of the LF-LAM result, which was correlated with the patient’s clinical course over theensuing 6 months.Results:The study enrolled 54 inpatients and 463 outpatients between July 1 and December 31, 2015. On enrolment,the patients’median (interquartile range) CD4 T-cell count was 270 (128–443) cells/mm3. The baseline LF-LAM testwas positive in 201/517 (39%). TB was confirmed microbiologically during follow-up in 54/517 (10%), with rifampicinresistance present in 8/54 (15%). In the study’s resource-limited setting, extrapulmonary testing for TB was not possible,but after 6 months, 97/201 (48%) with a positive LF-LAM test on enrolment had neither died, required hospitalisation,received a TB diagnosis or received empirical anti-TB therapy, suggesting a high rate of false-positive results.Of the 97 false-positive tests, 89 (92%) were grade 1 positive, suggesting poor test specificity using this cut-off. Only21/517 (4%) patients were inpatients with TB symptoms and a CD4 T-cell count of \u003c 100 cells/mm3. Five (24%) of these21 died, three of whom had a positive LF-LAM test on enrolment. However, all three received anti-TB therapy beforedeath—two after diagnosis with Xpert MTB/RIF testing, while the other received empirical treatment. It is unlikely thatknowledge of the baseline LF-LAM result would have averted any of the study’s other 11 deaths; eight had a negativetest, and of the three patients with a positive test, two received anti-TB therapy before death, while one died fromlaboratory-confirmed cryptococcal meningitis. The test was no better than a simple, clinical history excluding TB duringfollow-up (negative predictive value (95% confidence interval): 94% (91–97) vs. 94% (91–96)).\nConclusions:The LF-LAM test had limited clinical utility in the management of HIV-positive patients in this Asianreferral hospital setting."}]}, "item_1583103108160": {"attribute_name": "Keywords", "attribute_value_mlt": [{"interim": "Human immunodeficiency virus"}, {"interim": "Tuberculosis"}, {"interim": "Diagnostic test"}, {"interim": "Clinical management"}, {"interim": "Myanmar"}]}, "item_1583103120197": {"attribute_name": "Files", "attribute_type": "file", "attribute_value_mlt": [{"accessrole": "open_access", "date": [{"dateType": "Available", "dateValue": "2021-01-28"}], "displaytype": "preview", "download_preview_message": "", "file_order": 0, "filename": "The_clinical_utility_of_the_urine-based_lateral_fl.pdf", "filesize": [{"value": "1008 KB"}], "format": "application/pdf", "future_date_message": "", "is_thumbnail": false, "licensetype": "license_0", "mimetype": "application/pdf", "size": 1008000.0, "url": {"url": "https://meral.edu.mm/record/7886/files/The_clinical_utility_of_the_urine-based_lateral_fl.pdf"}, "version_id": "ba6012b0-69de-465f-9374-7d3beec14578"}]}, "item_1583103131163": {"attribute_name": "Journal articles", "attribute_value_mlt": [{"subitem_issue": "15", "subitem_journal_title": "BMC Medicine", "subitem_pages": "1-11"}]}, "item_1583105942107": {"attribute_name": "Authors", "attribute_value_mlt": [{"subitem_authors": [{"subitem_authors_fullname": "Swe Swe Thit"}, {"subitem_authors_fullname": "Ne Myo Aung"}, {"subitem_authors_fullname": "Zaw Win Htet"}, {"subitem_authors_fullname": "Boyd, Mark A."}, {"subitem_authors_fullname": "Htin Aung Saw"}, {"subitem_authors_fullname": "Anstey, Nicholas M."}, {"subitem_authors_fullname": "Tint Tint Kyi"}, {"subitem_authors_fullname": "Cooper,  David A."}, {"subitem_authors_fullname": "Mar Mar Kyi"}, {"subitem_authors_fullname": "Hanson, Josh"}]}]}, "item_1583108359239": {"attribute_name": "Upload type", "attribute_value_mlt": [{"interim": "Publication"}]}, "item_1583108428133": {"attribute_name": "Publication type", "attribute_value_mlt": [{"interim": "Journal article"}]}, "item_1583159729339": {"attribute_name": "Publication date", "attribute_value": "2017-02-28"}, "item_1583159847033": {"attribute_name": "Identifier", "attribute_value": "DOI 10.1186/s12916-017-0888-3"}, "item_title": "The clinical utility of the urine-basedlateral flow lipoarabinomannan assayin HIV-infected adults in Myanmar:an observational study", "item_type_id": "21", "owner": "100", "path": ["1608053322572"], "permalink_uri": "http://hdl.handle.net/20.500.12678/0000007886", "pubdate": {"attribute_name": "Deposited date", "attribute_value": "2021-01-28"}, "publish_date": "2021-01-28", "publish_status": "0", "recid": "7886", "relation": {}, "relation_version_is_last": true, "title": ["The clinical utility of the urine-basedlateral flow lipoarabinomannan assayin HIV-infected adults in Myanmar:an observational study"], "weko_shared_id": -1}