Sputum induction, bronchoalveolar lavage, or gastric aspiration are often needed to produce adequate diagnostic respiratory samples from people with HIV in whom tuberculosis is suspected. Since these procedures are rarely appropriate in less-developed countries, we compared the performances of a simple string test and the gold-standard sputum induction. 160 HIV-positive adults under investigation for tuberculosis, and 52 asymptomatic HIV-positive control patients underwent the string test followed by sputum induction. The string test detected tuberculosis in 14 patients in whom this disease was suspected; sputum induction detected only eight of them (McNemar's test, p=0·03). These preliminary data suggest that the string test is safe and effective for retrieval of useful clinical specimens for diagnosis of pulmonary tuberculosis, and is at least as sensitive as sputum induction.
Bibliographical noteFunding Information:
This study was jointly funded by the Office of Health, Infectious Diseases, and Nutrition, Global Health Bureau, US Agency for International Development, under the terms of Award No # HRN-5986-A-00-6006-00, GHS-A-00-03-00019-00, Global Research Activity Cooperative Agreement, NIH/NIAID (T35A107646), The Wellcome Trust and RG-ER Fund. The funding sources had no role in the study design, data collection, data interpretation, data analysis, or writing of the report. The corresponding author had full access to all the data in the study and had final responsibility for the decision to submit for publication. The opinions expressed herein are those of the author(s) and do not necessarily reflect the views of the US Agency for International Development.