The impact of Lateral Flow Urine (LAM) Test on TB Case notifications among people living with HIV at Levy Mwanawasa Teaching Hospital, Zambia: Quasi Experimental Study Design

Abstract

The main aim of this study was to assess the impact of LF- LAM test on TB notifications. The specific objectives was to describe trends in TB notifications among people living with HIV, determine the effect of LAM test introduction on TB case notification among HIV positive individuals and compare the median turnaround time of results between GeneXpert and LAM test. This research was a quasi-experimental study design which was conducted at Levy Mwanawasa Teaching Hospital in Lusaka with a focusing on determining improvement in TB notifications following the introduction of urine Lam test. TB notifications were collected from 2017 to 2021 and data divided into 2 segments; the first segment comprised notifications before the introduction of TB LAM, and the second segment was the TB notifications after the intervention. A total of 404 records for HIV infected TB patients in the TB registers were reviewed for 18 quarters from 2017 to 2021. The median (IQR) age of the patients was 38 years. The interrupted series results showed a non-significant reduction of 0.74 points per quarter prior to the implementation. The post intervention trend in TB notifications reduced by 0.1 points (95% CI 6.2-6.0), though not statistically significant reduction. The introduction of TB LAM was not associated with improved TB case notification. The current Xpert test being used for TB diagnosis is remains appropriate for the present treatment algorithm. However, there is still need to conduct future studies at a non-referral site to establish the real impact of the use of TB LAM in people living with HIV.