Backgrounds : Tuberculosis is a global public health emergency, and tuberculous meningitis is the most severe manifestation of tuberculosis. Tuberculous meningitis detection is difficult, combination of clinical, laboratory and radiological criterias were used in diagnostic approach. Urinary lipoarabinomannan (LAM) antigen detection is a promising diagnostic tools because urine sample is obtainable without the need of invasive methods. ELISA examination of tuberculosis antigen in concentrated urine sample is predicted to improve the performance of tuberculous antigen with ELISA method. The purpose of this study is to describe the LAM ELISA examination in concentrated and unconcentrated urine of tuberculous meningitis patients.
Methods : This research is a descriptive, cross-sectionally designed. The study was conducted in the laboratory of clinical microbiology and clinical immunology department/SMF Clinical Pathology Dr. Hasan Sadikin hospital, in July_October 2014. A total of 26 tuberculous meningitis patients diagnosis were included and the subjects were classified into possible, probable and definite criteria according to Marais criteria. The subjects were examined for the presence of LAM in unconcentrated and concentrated urine with ELISA method.
Results : Unconcentrated urinary LAM examination positivity was 0% while in concentrated urine was 14,8 %.The positivity of concentrated urinary lipoarabinomannan were higher among the definite criteria group.
Conclusion : Concentrating urine sample increase the positivity of urinary LAM detection with ELISA method as high as 14,8%. The urinary antigen excretion is higher among the definitely tuberculous meningitis patients according to Marais criteria
Keywords : LAM . Concentrated Urine . Tuberculous meningitis