Abstract
BACKGROUND: An immunochromatographic assay (ICT Diagnostics) which facilitates the diagnosis
of tuberculosis(TB) by detecting serum antibodies mainly directed against specific 38KDa of
Mycobacterium tuberculosis has come into the market. The test consists of a cardboard folding
device containing nitrocellulose strip and absorbent pads. The whole procedure is completed
within 15 min and does not require any additional equipment. The test has been reported to
be sensitive and specific in diagnosing active TB. Thus the test had been evaluated with
sera from TB patients and TB-free subjects.
METHOD: Sera from patients with active pulmonary tuberculosis(40 sputum positives for
Mycobacterium tuberculosis, 79 sputum negatives, and 3 extrapulmonary tuberculosis) were
obtained from the Double-Cross Chest Clinic of the Korean National Tuberculosis Association
(KNTA) in Seoul. The control group consisted of TB-free 68 subjects(21 children under 7 years
old and 47 healthy staff members of KNTA).
RESULTS: Nine out of 68(13.2%) TB-free controls had positive antibody response. Total 106 of
122(86.9%) radiologically active patients had positive antibodies while 16 (13.1%) showed
negative reaction. Antibody was detected in 38 of 40(95.0%) sputum positive patients and 68
of 82(82.9%) sputum negative patients who were under the antituberculosis chemotherapy.
The sensitivity and specificity were all 87% and the positive predictive value was 92.2%
while the negative predictive value was 78.7%, when the prevalence of TB in the sample was
64.2%. It is clear from our results that the detection of antibodies which mainly react
with the 38KDa antigen of M. tuberculosis should not be suitable as first-line method of
diagnosis, but considered only as an adjunctive test to standard techniques of tuberculosis
diagnosis, when considering its high false positivity.