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Table 1 Studies reporting urinary LAM detection and mortality included in the systematic review

From: Detection of lipoarabinomannan (LAM) in urine is an independent predictor of mortality risk in patients receiving treatment for HIV-associated tuberculosis in sub-Saharan Africa: a systematic review and meta-analysis

Study LAM assay used (type of urine sample) Study setting and population (country) Median CD4 cell count (by LAM status if presented) (cells/μl) Number of TB cases/total number in study (prevalence %) Number of urinary LAM-positive TB cases (%) Duration of follow-up (months) Overall mortality in TB cases (%) Number of TB deaths/number of TB cases (%) RR of mortalitya (95 % CI) Quality assessment scoreb
LAM positive LAM negative
Shah et al. (2009) [47] Clearview TB ELISA (frozen urine) Hospitalised patients; TB suspected (South Africa) 79 193/499 (38.7) 114 (59.1) 2 22.3 31/114 (27.2) 12/79 (15.2) 1.8 (1.0–3.3) 60
Lawn et al. (2012) [48] Determine TB-LAM lateral flow assay (frozen urine) Outpatient clinic; patients initiating ART (South Africa) 100 (LAM-positive 37; LAM-negative 115) 59/325 (18.2) 23 (39.0) 3 8.5 5/23 (21.7) 0/36 (0.0) NA 70
Talbot et al. (2012) [49] Clearview TB ELISA (fresh and frozen urine) Hospitalised patients; TB suspected (Tanzania) 86 69/212 (32.5) 45 (65.2) 2 52.9 25/38 (65.8) 33/83 (39.8) 1.7 (1.2–2.3) 75
Peter et al. (2013) [50] Determine TB-LAM lateral flow assay (frozen urine) Hospitalised patients; TB suspected (South Africa) 89 (LAM-positive 62; LAM-negative 180) 116/281 (4.2) 58 (50.0) 2 13.9 6/25 (24.0)c 1/23 (8.5)c 5.5 (0.7–42.4) 80
Balcha et al. (2014) [51] Determine TB-LAM lateral flow assay (frozen urine) Outpatient clinic; ART naïve; sputum producers (Ethiopia) 176 (LAM-positive 94; LAM-negative 187) 128/757 (16.9) 35 (27.3) 6 6.8 7/35 (20.0) 3/113 (2.7) 7.5 (2.1–27.6) 60
Manabe et al. (2014) [28] Determine TB-LAM lateral flow assay (fresh urine) Hospitalised patients; TB suspects (Uganda) 57 145/351 (41.3) 90 (62.1) 2 22.1 25/90 (27.8) 7/37 (12.7) 2.2 (1.0–4.7) 75
Drain et al. (2015) [52] Determine TB-LAM lateral flow assay (frozen urine) Outpatient clinic; patients initiating TB treatment (South Africa) 168 (LAM-positive 106; LAM-negative 198) 90/90 (100.0) 29 (22.2) 36 27.8 9/29 (31.0) 16/61 (26.2) 1.2 (0.6–2.4) 70
Peter et al. (2015) [53] Determine TB-LAM lateral flow assay (frozen urine) Hospitalised patients; TB suspected (South Africa) 210 181/583 (31.0) 41 (22.7) 6 13.0 6/17 (35.2) 15/106 (14.2) 2.5 (1.1–5.5) 85
Lawn et al. (2015) [54] Determine TB-LAM lateral flow assay (frozen urine) Hospitalised patients; all HIV+ patients (South Africa) 148 136/427 (31.2) 53 (39.0) 3 13.7 13/5 (24.5) 6/83 (7.2) 3.4 (1.4–8.4) 75
Bjerrum et al. (2015) [55] Determine TB-LAM lateral flow assay (fresh urine) Hospital inpatient and outpatient; TB suspected (Ghana) 127 55/469 (11.7) 24 (43.6) 6 32.7 13/24 (54.2) 5/31 (16.1) 3.4 (1.4–8.1) 70
  1. ART antiretroviral therapy, CI confidence interval, ELISA enzyme-linked immunosorbent assay, LAM lipoarabinomannan, NA not applicable, RR relative risk, TB tuberculosis. aUrinary LAM-positive TB cases compared to urinary LAM-negative TB cases. bQuality assessment score graded as follows: (<50 poor, 50–74 moderate, >74 good. cMortality in TB cases with urinary LAM results only reported in patients who did not receive ‘early empirical TB therapy’