Diagnosis of tuberculosis

394: 442: 426: 410: 3261: 618: 970:

Determine TB LAM Ag and the Fujifilm SILVAMP TB LAM could diagnose 65% of patients with active TB within 24 h. A meta-analysis with 1,595 inpatients and outpatients showed 70% sensitivity and 90% specificity for TB diagnosis in people living with HIV for Fujifilm SILVAMP TB LAM. As of 2020, the test showed a high positive predictive value (95.2%) in HIV-negative outpatients. Large prospective studies are on the way.

481: 888:

performance of IGRA. A recently published study from the same group also provided evidence that immunosuppressive agents significantly impair the performance of IGRAs, raising concerns about their reliability in immunosuppressed patients. Although IGRA replaced the TST in most of clinical settings its variability as of 2013 was a concern while reading the result

626: 38: 383:(LJ), Kirchner, or Middlebrook media (7H9, 7H10, and 7H11). A culture of the AFB can distinguish the various forms of mycobacteria, although results from this may take four to eight weeks for a conclusive answer. New automated systems that are faster include the MB/BacT, BACTEC 9000, VersaTREK, and the Mycobacterial Growth Indicator Tube (MGIT). The 173: 884:

specificity of 86.3%. In head-to-head comparisons, the sensitivity of IGRAs surpassed TST. However, several subsequent studies have reported higher sensitivity for TST than for IGRAs in patients with active TB; one large 2017 study reported a sensitivity of 90% for TST and only of 81% for the QuantiFERON-TB Gold assay.

322:. These tests vary in which nucleic acid sequence they detect and vary in their accuracy. In the decade of the 2000s, the two most common commercially available tests were the amplified mycobacterium tuberculosis direct test (MTD, Gen-Probe) and Amplicor (Roche Diagnostics). In 2007, a systematic review of NAAT by the 111:. Other parts of the medical history include prior TB exposure, infection or disease and medical conditions that increase risk for TB disease such as HIV infection. Depending on the sort of patient population surveyed, as few as 20%, or as many as 75% of pulmonary tuberculosis cases may be without symptoms. 925:

of 12 cross-sectional or cohort studies that showed a relatively low pooled sensitivity of 45% and specificity of 92% against a microbiological reference standard. Despite the limited sensitivity, test-guided initiation of anti-TB treatment reduced mortality in immunocompromised, hospitalized PLHIV.

916:

recommended the use of the Alere Determine TB LAM Ag assay for people with HIV and a CD4 count below 100 cells/μL and in those defined as seriously ill according to WHO criteria (respiratory rate >30 breaths per min, body temperature >39 °C, heart rate >120 beats per min, or unable to

828:

for early secretory antigen target 6 (ESAT-6) and culture filtrate protein 10 (CFP-10) to stimulate host production of interferon-gamma. Because these antigens are only present in few non-tuberculous mycobacteria or not in any BCG vaccine strain, these tests are thought to be more specific than the

2449:

Peter JG, Zijenah LS, Chanda D, Clowes P, Lesosky M, Gina P, et al. (March 2016). "Effect on mortality of point-of-care, urine-based lipoarabinomannan testing to guide tuberculosis treatment initiation in HIV-positive hospital inpatients: a pragmatic, parallel-group, multicountry, open-label,

887:

A 2012 study at Stanford University confirmed that addition of immune boosters can make the IGRA more reliable in terms of separating positive from negative individuals. A study from the University of Southampton shows that variations in environmental temperatures can have a profound effect on the

345:

NAA techniques such as polymerase chain reaction (PCR) and loop-mediated isothermal amplification (LAMP) are the basis of molecular diagnosis of TB. To detection of MTB in samples different molecular methods and assays have been defined. Real-time PCR (RT-PCR), microarrays, PURE-LAMP, NGS, and WGS

326:

Health Technology Assessment Programme concluded that "NAAT test accuracy to be far superior when applied to respiratory samples as opposed to other specimens. Although the results were not statistically significant, the AMTD test appears to perform better than other currently available commercial

1027:

circulating within blood vessels of a patient. The skin patch contains antibodies recognizing the secreted bacterial protein MPB-64 passing through the blood capillaries of the skin creating an immunological response. If the patch detects this secreted bacterial protein, the surrounding skin will

535:

FDG PET/CT can play several useful roles in patients with confirmed or suspected TB. These roles include detection of active TB lesions, assessment of disease activity, differentiation between active and latent disease, assessment of disease extent (staging), monitoring response to treatment, and

908:

antigen is a lipopolysaccharide present in mycobacterial cell walls, which is released from metabolically active or degenerating bacterial cells and appears to be present only in people with active TB disease. Urine-based testing have advantages over sputum-based testing because urine is easy to

969:

directed towards the 5-methylthio-d-xylofuranose (MTX) epitope and a silver amplification technology to enable higher diagnostic sensitivity at high specificity. A 2019 study with 968 HIV+ hospital inpatients found the Fujifilm SILVAMP TB LAM test to have a 28% higher sensitivity than the Alere

883:

TB, due to their ability to detect latent TB. In a recently published metaanalysis, with data from both developed and developing countries, QuantiFERON-TB Gold In Tube had a pooled sensitivity for active TB of 81% and specificity of 99.2%, whereas T-SPOT.TB had a pooled sensitivity of 87.5% and

1014:

Health Technology Assessment Programme concluded "There is no evidence to support the use of ADA tests for the diagnosis of pulmonary TB. However, there is considerable evidence to support their use in pleural fluid samples for diagnosis of pleural TB, where sensitivity was very high, and to a

782:

the US Centers for Disease Control and Prevention state that whereas Quantiferon Gold is not affected by BCG inoculation tuberculin tests can be affected. In general the US approach is likely to result in more false positives and more unnecessary treatment with potentially toxic drugs; the UK

812:

Interferon-γ (interferon-gamma) release assays (IGRAs) are 21st century tests for tuberculosis. Guidelines for the use of the FDA approved QuantiFERON-TB Gold were released by the CDC in December 2005. In October 2007, the FDA gave approval of QuantiFERON-TB Gold In Tube for use in the United

515:

Abnormalities on chest radiographs may be suggestive of, but are not necessarily diagnostic of, TB. However, chest radiographs may be used to rule out the possibility of pulmonary TB in a person who has a positive reaction to the tuberculin skin test and no symptoms of the disease.

507:

with or without mediastinal or hilar lymphadenopathy or pleural effusions ( tuberculous pleurisy). However, lesions may appear anywhere in the lungs. In disseminated TB a pattern of many tiny nodules throughout the lung fields is common - the so-called miliary TB. In HIV and other

327:

tests." Xpert ® MTB/RIF and Xpert MTB/RIF Ultra has high specificity in diagnosing extrapulmonary tuberculosis and is accurate in detecting rifampicin resistance. However, clinicians should rely on clinical judgement to diagnose TB meningitis when culture results are negative.

224:, biopsied tissue, etc.). A diagnosis made other than by culture may only be classified as "probable" or "presumed". For a diagnosis negating the possibility of tuberculosis infection, most protocols require that two separate cultures both test negative. 1056:) to detect the "scent" of tuberculosis. A recent study shows that "rats increased pediatric tuberculosis detection by 67.6%" and that training these creatures could help address the current challenges related to the diagnosis of this illness in children. 346:

are assays that applicable for all taxa and genes, but some assays have been designed for correct and specific detection of MTB such as Amplicor MTB, Cobas TaqMan MTB, E-MTD, FluoroType MTB, LPA (Genotype MTB/R), Anyplex MTB, Xpert MTB, and Genedrive MTB

864:

format to detect the whole blood production of interferon γ. The distinction between the tests is that QuantiFERON-TB Gold quantifies the total amount of interferon γ when whole blood is exposed to the antigens(ESAT-6, CFP-10 and TB 7.7(p4)), whereas

772:

There is disagreement on the use of the Mantoux test on people who have been immunized with BCG. The US recommendation is that in administering and interpreting the Mantoux test, previous BCG vaccination should be ignored; the UK recommendation is that

393: 130:

is done to assess the patient's general health. It cannot be used to confirm or rule out TB. However, certain findings are suggestive of TB. For example, blood in the sputum, significant weight loss and drenching night sweats may be due to TB.

248:. In cases where there is no spontaneous sputum production, a sample can be induced, usually by inhalation of a nebulized saline or saline with bronchodilator solution. A comparative study found that inducing three sputum samples is more 1907:

Ewer K, Deeks J, Alvarez L, Bryant G, Waller S, Andersen P, et al. (April 2003). "Comparison of T-cell-based assay with tuberculin skin test for diagnosis of Mycobacterium tuberculosis infection in a school tuberculosis outbreak".

2027:

Kang YA, Lee HW, Hwang SS, Um SW, Han SK, Shim YS, et al. (September 2007). "Usefulness of whole-blood interferon-gamma assay and interferon-gamma enzyme-linked immunospot assay in the diagnosis of active pulmonary tuberculosis".

1348:

Guerra RL, Hooper NM, Baker JF, Alborz R, Armstrong DT, Maltas G, et al. (September 2007). "Use of the amplified mycobacterium tuberculosis direct test in a public health laboratory: test performance and impact on clinical care".

1814:

Ferrara G, Losi M, D'Amico R, Roversi P, Piro R, Meacci M, et al. (April 2006). "Use in routine clinical practice of two commercial blood tests for diagnosis of infection with Mycobacterium tuberculosis: a prospective study".

2236: 3719: 1951:

Lalvani A, Pathan AA, Durkan H, Wilkinson KA, Whelan A, Deeks JJ, et al. (June 2001). "Enhanced contact tracing and spatial tracking of Mycobacterium tuberculosis infection by enumeration of antigen-specific T cells".

2100:"Safety and efficacy of the C-Tb skin test to diagnose Mycobacterium tuberculosis infection, compared with an interferon γ release assay and the tuberculin skin test: a phase 3, double-blind, randomised, controlled trial" 777:

should be used to help interpret positive tuberculin tests, also, the UK does not recommend serial tuberculin skin testing in people who have had BCG (a key part of the US strategy). In their guidelines on the use of

114:

Tuberculosis should be suspected in adults when a pneumonia-like illness has persisted longer than three weeks, or when a respiratory illness in an otherwise healthy individual does not respond to regular antibiotics.

688:

An induration (palpable raised hardened area of skin) of more than 5–15 mm (depending upon the person's risk factors) to 10 Mantoux units is considered a positive result, indicating TB infection.

425: 3664: 2495:"Rapid urine-based screening for tuberculosis in HIV-positive patients admitted to hospital in Africa (STAMP): a pragmatic, multicentre, parallel-group, double-blind, randomised controlled trial" 1167:

Steingart KR, Henry M, Ng V, Hopewell PC, Ramsay A, Cunningham J, et al. (September 2006). "Fluorescence versus conventional sputum smear microscopy for tuberculosis: a systematic review".

3709: 3699: 107:. Systemic symptoms include low grade remittent fever, chills, night sweats, appetite loss, weight loss, easy fatiguability, and production of sputum that starts out mucoid but changes to 409: 3684: 2858:

Nakamura RM, Einck L, Velmonte MA, Kawajiri K, Ang CF, Delasllagas CE, et al. (2001-01-01). "Detection of active tuberculosis by an MPB-64 transdermal patch: a field study".

3111: 558:) was a small radiographic image, also called miniature mass radiography (MMR) or miniature chest radiograph. Though its resolution is limited (it doesn't allow the diagnosis of 1771:

Menzies D, Pai M, Comstock G (March 2007). "Meta-analysis: new tests for the diagnosis of latent tuberculosis infection: areas of uncertainty and recommendations for research".

357:

said in 2015, it began "revolutionizing tuberculosis (TB) control by contributing to the rapid diagnosis of TB disease and drug resistance. The test simultaneously detects

2674:"Diagnostic accuracy of a novel tuberculosis point-of-care urine lipoarabinomannan assay for people living with HIV: A meta-analysis of individual in- and outpatient data" 1204:"Prospective study of sputum induction, gastric washing, and bronchoalveolar lavage for the diagnosis of pulmonary tuberculosis in patients who are unable to expectorate" 118:

The diagnosis is particularly challenging in children because they more commonly have extrapulmonary disease and present with less mycobacteria (paucibacillary disease).

3365: 1724:

Pelletier-Galarneau M, Martineau P, Zuckier LS, Pham X, Lambert R, Turpin S (May 2017). "18F-FDG-PET/CT Imaging of Thoracic and Extrathoracic Tuberculosis in Children".

384: 879:

According to a 2007 study from Korea, a high prevalence country of LTBI, QuantiFERON-TB Gold and T-SPOT.TB have good sensitivity but reduced specificity for diagnosing

1450: 2063:

Diel R, Loddenkemper R, Nienhaus A (April 2010). "Evidence-based comparison of commercial interferon-gamma release assays for detecting active TB: a metaanalysis".

958: 441: 2573:"A Novel Sensitive Immunoassay Targeting the 5-Methylthio-d-Xylofuranose-Lipoarabinomannan Epitope Meets the WHO's Performance Target for Tuberculosis Diagnosis" 3654: 76:

bacteria in a clinical specimen taken from the patient. While other investigations may strongly suggest tuberculosis as the diagnosis, they cannot confirm it.

1686:

Rossi SE, Franquet T, Volpacchio M, Giménez A, Aguilar G (1 May 2005). "Tree-in-bud pattern at thin-section CT of the lungs: radiologic-pathologic overview".

821:

of IGRAs concluded the tests noted excellent specificity for the tests to distinguish latent TB from prior vaccination. IGRAs are based on the ability of the

576:

The procedure went out of favor, as the incidence of tuberculosis dramatically decreased, but is still used in certain situations, such as the screening of

1487:"The New Xpert MTB/RIF Ultra: Improving Detection of Mycobacterium tuberculosis and Resistance to Rifampin in an Assay Suitable for Point-of-Care Testing" 3649: 1446: 638: 354: 150: 868:

As of 2003, the enzyme-linked immunospot assay (ELISPOT) has been another blood test available in the UK that may replace the skin test for diagnosis.

934: 138: 637:

The Mantoux skin test is used in the United States and is endorsed by the American Thoracic Society and Centers for Disease Control and Prevention (

3520: 790:

infection (LTBI) is considered for any BCG-vaccinated person whose skin test is 10 mm or greater, if any of these circumstances are present:

2378:"The use of lateral flow urine lipoarabinomannan assay (LF-LAM) for the diagnosis and screening of active tuberculosis in people living with HIV" 342:

99%. In Smear positive patients high sensitivity 99%, specificity 98%. In smear negative patients low sensitivity 62%, but high specificity 99%.

3856: 3694: 3147: 565:

Much less expensive than traditional X-Ray, MMR was quickly adopted and extensively utilized in some countries, in the 1950s. For example, in

1089: 633:

for TB involves intradermally injecting PPD (Purified Protein Derivative) tuberculin and measuring the size of induration 48-72 hours later.

334:

found that use of the MTD test reduced inappropriate tuberculosis therapy. The study found the accuracy of the MTD test as follows: Overall

315: 2139:"In vitro immunomodulation of a whole blood IFN-γ release assay enhances T cell responses in subjects with latent tuberculosis infection" 304:

from other mycobacteria. Even if sputum smear is negative, tuberculosis must be considered and is only excluded after negative cultures.

3525: 1015:

slightly lesser extent for TB meningitis. In both pleural TB and TB meningitis, ADA tests had higher sensitivity than any other tests."

3108: 3333: 359: 3461: 2800:"Diagnostic Accuracy of the Cepheid 3-gene Host Response Fingerstick Blood Test in a Prospective, Multi-site Study: Interim Results" 1041: 260:

In patients incapable of producing a sputum sample, common alternative sample sources for diagnosing pulmonary tuberculosis include

3689: 3515: 3329: 2237:"Corticosteroids and infliximab impair the performance of interferon-γ release assays used for diagnosis of latent tuberculosis" 3260: 469: 199: 3348: 3250: 2902: 774: 399:

Pulmonary tuberculosis characterized by granulomatous inflammation with necrotizing epithelioid granulomas. Low power view.

2377: 718:

Residents and employees of high-risk congregate settings (e.g., prisons, nursing homes, hospitals, homeless shelters, etc.)

3815: 3659: 3644: 1461: 2542: 380: 280:(transtracheal or transbronchial). In some cases, a more invasive technique is necessary, including tissue biopsy during 3669: 991: 982:

looking for messenger RNA (mRNA) expression of 3 genes in response to TB. The Xpert MTB Host Response test calculated a

764:

A tuberculin test conversion is defined as an increase of 10 mm or more within a 2-year period, regardless of age.

3805: 3188: 492: 134: 2099: 367:(RIF) in less than 2 hours. In comparison, standard cultures can take 2 to 6 weeks for MTBC to grow and conventional 3780: 3603: 3299: 3140: 2289:"Impact of blood volume, tube shaking, and incubation time on reproducibility of QuantiFERON-TB gold in-tube assay" 1760:

Guidelines for Using the QuantiFERON-TB Gold Test for Detecting Mycobacterium tuberculosis Infection, United States

1049: 212: 179: 72: 3099:

University of Washington Molecular Diagnosis, Microbiology Division | PCR-based detection in direct tissue samples

1293:"Xpert MTB/RIF Ultra and Xpert MTB/RIF assays for extrapulmonary tuberculosis and rifampicin resistance in adults" 3628: 3568: 3245: 3218: 2543:"Diagnostic accuracy study published on next-generation urine test to detect tuberculosis in HIV-positive people" 987: 913: 311: 297: 573:, tuberculosis prevention laws went into effect, obligating ca. 60% of the population to undergo MMR screening. 3750: 965:

LAM assay. Compared with the Alere Determine TB LAM Ag assay, the Fujifilm SILVAMP TB LAM assay includes novel

930: 783:

approach is as sensitive in theory and should also be more specific, because of the use of interferon-γ tests.

527:

may appear on the chest CTs of some patients affected by tuberculosis, but it is not specific to tuberculosis.

241: 3318: 2493:

Gupta-Wright A, Corbett EL, van Oosterhout JJ, Wilson D, Grint D, Alufandika-Moyo M, et al. (July 2018).

245: 46: 3755: 3535: 3397: 3338: 3278: 3203: 3066:

Medical Examination of Aliens (Refugees and Immigrants) - Division of Global Migration and Quarantine, CDC (

1011: 995: 942: 918: 323: 237: 233: 236:

should be done for acid-fast bacilli if the patient is producing sputum. The preferred method for this is

3830: 3820: 3714: 3310: 3223: 3172: 3119: 2625:"Novel lipoarabinomannan point-of-care tuberculosis test for people with HIV: a diagnostic accuracy study" 458: 368: 277: 2571:

Sigal GB, Pinter A, Lowary TL, Kawasaki M, Li A, Mathew A, et al. (December 2018). Miller MB (ed.).

3851: 3810: 3704: 3471: 3416: 3323: 3133: 962: 954: 950: 901: 747:

Children less than 4 years of age, or children and adolescents exposed to adults in high-risk categories

3578: 1545:

Drobniewski FA, Caws M, Gibson A, Young D (March 2003). "Modern laboratory diagnosis of tuberculosis".

1100:

Burke and Parnell. Minimal Pulmonary Tuberculosis. 1948. 59:348 Canadian Medical Association Journal.

2798:

Sutherland JS, van der Spuy G, Gindeh A, Thuong NT, Namuganga A, Owolabi O, et al. (2021-09-22).

2725:"Diagnostic accuracy of three urine lipoarabinomannan tuberculosis assays in HIV-negative outpatients" 3760: 3674: 3292: 3228: 2402:"Lateral flow urine lipoarabinomannan assay for detecting active tuberculosis in HIV-positive adults" 2150: 1384:

Mousavi-Sagharchi SM, Afrazeh E, Seyyedian-Nikjeh SF, Meskini M, Doroud D, Siadat SD (21 June 2024).

983: 845: 598: 555: 261: 127: 88: 87:

and microbiological examination (of sputum or some other appropriate sample). It may also include a

2623:

Broger T, Sossen B, du Toit E, Kerkhoff AD, Schutz C, Ivanova Reipold E, et al. (August 2019).

3724: 3679: 3285: 3235: 3208: 2013: 1007: 966: 787: 644:

If a person has had a history of a positive tuberculin skin test, another skin test is not needed.

339: 335: 331: 249: 221: 2098:

Ruhwald M, Aggerbeck H, Gallardo RV, Hoff ST, Villate JI, Borregaard B, et al. (April 2017).

503:

In active pulmonary TB, infiltrates or consolidations and/or cavities are often seen in the upper

3098: 2883: 2475: 2269: 1977: 1933: 1840: 1796: 1149: 946: 509: 1291:

Kohli M, Schiller I, Dendukuri N, Yao M, Dheda K, Denkinger CM, et al. (January 15, 2021).

480: 3085: 617: 3343: 3181: 3047: 3002: 2949: 2875: 2837: 2819: 2756: 2705: 2654: 2602: 2524: 2467: 2431: 2359: 2318: 2261: 2217: 2178: 2119: 2080: 2045: 1969: 1925: 1889: 1832: 1788: 1741: 1703: 1662: 1611: 1562: 1524: 1506: 1485:

Chakravorty S, Simmons AM, Rowneki M, Parmar H, Cao Y, Ryan J, et al. (August 29, 2017).

1425: 1407: 1366: 1330: 1312: 1273: 1225: 1184: 1141: 1133: 1085: 979: 905: 897: 818: 350: 307: 512:

persons, any abnormality may indicate TB or the chest X-ray may even appear entirely normal.

3608: 3193: 3037: 3027: 2992: 2984: 2939: 2867: 2827: 2811: 2746: 2736: 2695: 2685: 2644: 2636: 2592: 2584: 2514: 2506: 2459: 2421: 2413: 2349: 2308: 2300: 2251: 2209: 2198:"Environmental temperature impacts on the performance of QuantiFERON-TB Gold In-Tube assays" 2168: 2158: 2111: 2072: 2037: 1995: 1961: 1917: 1879: 1871: 1824: 1784: 1780: 1733: 1695: 1652: 1642: 1601: 1593: 1554: 1514: 1498: 1415: 1397: 1358: 1320: 1304: 1263: 1215: 1176: 1123: 909:

collect and store, and lacks the infection control risks associated with sputum collection.

779: 524: 520: 1580:

Moore DA, Evans CA, Gilman RH, Caviedes L, Coronel J, Vivar A, et al. (October 2006).

1252:"A systematic review of rapid diagnostic tests for the detection of tuberculosis infection" 669:

The equivalent Mantoux test positive levels done with 10 TU (0.1 ml 100 TU/ml, 1:1000) are

379:

Many types of microbiological culture are available. Traditionally, cultures have used the

3825: 3598: 3588: 3558: 3553: 3548: 3543: 3115: 496: 281: 3618: 3077: 2400:

Shah M, Hanrahan C, Wang ZY, Dendukuri N, Lawn SD, Denkinger CM, et al. (May 2016).

1759: 157:

is an important screening strategy to identify new arrivals who have a high risk for TB.

2196:

Jarvis J, Gao Y, de Graaf H, Hughes S, Allan RN, Williams A, et al. (August 2015).

2154: 1420: 1385: 3563: 3213: 3042: 3015: 2997: 2972: 2832: 2751: 2724: 2700: 2673: 2649: 2624: 2597: 2572: 2519: 2494: 2426: 2401: 2313: 2288: 2173: 2138: 1884: 1859: 1657: 1630: 1606: 1581: 1519: 1486: 1325: 1292: 729: 2672:

Broger T, Nicol MP, Székely R, Bjerrum S, Sossen B, Schutz C, et al. (May 2020).

2640: 2510: 2463: 2235:

Edwards A, Gao Y, Allan RN, Ball D, de Graaf H, Coelho T, et al. (October 2017).

2115: 1965: 1921: 1828: 1558: 1250:

Dinnes J, Deeks J, Kunst H, Gibson A, Cummins E, Waugh N, et al. (January 2007).

1180: 1128: 1111: 978:

In 2022, a study reported the use of a fingerstick blood point-of-care triage test by

758:(Note: Targeted skin testing programs should only be conducted among high-risk groups) 371:

can add 3 more weeks." The Xpert MTB/RIF Ultra improves upon the Xpert MTB/RIF test.

3845: 3613: 3583: 3441: 3269: 2887: 2723:

Broger T, Nicol M, Sigal G, Gotuzzo E, Zimmer AJ, Surtie S, et al. (July 2020).

1737: 1153: 922: 873: 741: 737: 2273: 1981: 1844: 1800: 662:

was used in the United Kingdom until 2005, and is graded on a four-point scale. The

3800: 3790: 3775: 3623: 3456: 3446: 3402: 3380: 3198: 3156: 2479: 2417: 1308: 663: 630: 612: 319: 318:(TMA) or other forms of nucleic acid amplification methods to detect mycobacterial 285: 269: 80: 67: 22: 2774: 2256: 1937: 844:

from the patient's blood are incubated with the antigens. These tests are called

432: 416: 400: 2690: 2550: 2163: 1080:

Kumar, Vinay; Abbas, Abul K.; Fausto, Nelson; & Mitchell, Richard N. (2007).

848:

and are not equivalent. If the patient has been exposed to tuberculosis before,

3729: 3593: 3479: 3451: 3431: 3426: 3353: 2338:"Tuberculosis diagnostics: which target product profiles should be prioritised?" 961:

completed the development and a first clinical study of the Fujifilm SILVAMP TB

857: 833: 581: 559: 551: 545: 519:

Cavitation or consolidation of the apexes of the upper lobes of the lung or the

137:(Class 0 to 5) used in the US is based on the pathogenesis of the disease. The 84: 2213: 2197: 1671: 1402: 3795: 3573: 3436: 3421: 3370: 3240: 3177: 2871: 2354: 2337: 853: 841: 504: 488: 189: 104: 3081: 2988: 2823: 1875: 1510: 1411: 1316: 1137: 701:

Persons with nodular or fibrotic changes on CXR consistent with old healed TB

3487: 3411: 3385: 3375: 3358: 3032: 2775:"FujiLAM Prospective Evaluation Trial - Full Text View - ClinicalTrials.gov" 869: 837: 659: 653: 142: 3067: 3051: 3006: 2953: 2928:"Pediatric tuberculosis detection using trained African giant pouched rats" 2879: 2841: 2760: 2709: 2658: 2606: 2528: 2471: 2435: 2363: 2322: 2265: 2221: 2182: 2123: 2084: 2049: 1973: 1929: 1893: 1836: 1792: 1745: 1707: 1666: 1615: 1582:"Microscopic-observation drug-susceptibility assay for the diagnosis of TB" 1566: 1528: 1429: 1370: 1334: 1277: 1229: 1188: 1145: 3074:

Targeted Tuberculin Testing and Treatment of Latent Tuberculosis Infection

2815: 2076: 2041: 1647: 1502: 1362: 876:, counts the number of activated T lymphocytes that secrete interferon γ. 625: 562:, for example) it is sufficiently accurate for diagnosis of tuberculosis. 431:

Pulmonary tuberculosis featuring necrotizing granulomas, high power view,

37: 3785: 2588: 2304: 1699: 1597: 1112:"Diagnostics for childhood tuberculosis: a marathon rather than a sprint" 1045: 938: 733: 725: 364: 108: 3720:

Phipps Institute for the Study, Treatment and Prevention of Tuberculosis

1202:

Brown M, Varia H, Bassett P, Davidson RN, Wall R, Pasvol G (June 2007).

272:(with bronchoalveolar lavage, bronchial washings, and/or transbronchial 3734: 2944: 2927: 825: 484: 172: 146: 2799: 2741: 99:

The medical history includes obtaining the symptoms of pulmonary TB:

3770: 3765: 3497: 3492: 1268: 1251: 1023:

The transdermal patch is an experimental method" of detecting active

849: 724:

Persons with clinical conditions that place them at high risk (e.g.,

577: 566: 353:

test, another NAAT for TB, became commercially available and, as the

310:(NAAT) for TB are a heterogeneous group of tests that use either the 273: 265: 217: 210:

A definitive diagnosis of tuberculosis can only be made by culturing

100: 50: 2973:"Spotting latent infection: the path to better tuberculosis control" 1860:"Spotting latent infection: the path to better tuberculosis control" 3104:

Oxford Immunotec Medical Diagnostics|TB Education and Learning Zone

1719: 1717: 1220: 1203: 704:

Patients with organ transplants and other immunosuppressed patients

2336:

Kik SV, Denkinger CM, Casenghi M, Vadnais C, Pai M (August 2014).

1386:"New insight in molecular detection of Mycobacterium tuberculosis" 1037: 861: 800:

Is continually exposed to populations where TB prevalence is high.

624: 616: 570: 479: 473: 468: 467: 712:

Recent arrivals (less than 5 years) from high-prevalent countries

296:

Other mycobacteria are also acid-fast. If the smear is positive,

998:

2 genes to differentiate between active TB and other diseases.

3129: 3125: 83:(TB) must include a medical history, a physical examination, a 1451:"A New Tool to Diagnose Tuberculosis: The Xpert MTB/RIF Assay" 3665:

European and Developing Countries Clinical Trials Partnership

1631:"Peritoneal tuberculosis mimicking peritoneal carcinomatosis" 216:

organisms from a specimen taken from the patient (most often

141:

has an additional TB classification (Class A, B1, or B2) for

103:, prolonged cough of three or more weeks, chest pain, and 3710:

Mycobacterium Tuberculosis Structural Genomics Consortium

3700:

International Union Against Tuberculosis and Lung Disease

786:

Under the US recommendations, diagnosis and treatment of

523:

may be visible on an affected patient's chest X-ray. The

415:

Pulmonary tuberculosis featuring necrotizing granulomas,

3016:"Tuberculosis diagnostics: Challenges and opportunities" 2903:"With a little convincing, rats can detect tuberculosis" 3685:

The Global Fund to Fight AIDS, Tuberculosis and Malaria

896:

In 2014, tests based on the detection of mycobacterial

840:

use these antigens to detect people with tuberculosis.

797:

Was born or has resided in a high TB prevalence country

3103: 917:

walk unaided). This recommendation was informed by a

794:

Was in contact with another person with infectious TB

603:

Two tests are available: the Mantoux and Heaf tests.

2926:

Mgode GF, Cox CL, Mwimanzi S, Mulder C (July 2018).

3743: 3637: 3534: 3508: 3470: 3396: 3309: 3268: 3163: 198: 188: 57: 30: 1036:In 2018, the international nonprofit organization 974:Transcriptomic host response, polygenic risk score 387:culture may be a faster and more accurate method. 3366:Microscopic Observation Drug Susceptibility assay 1441: 1439: 385:Microscopic Observation Drug Susceptibility assay 1681: 1679: 679:Greater than 15 mm induration (Heaf 3 to 5) 476:like this one in the patient's right upper lobe. 1540: 1538: 959:Global Health Innovative Technology Fund (GHIT) 499:and peritoneal surfaces are thickened (arrows). 61:diagnosed by finding Mycobacterium tuberculosis 1245: 1243: 1241: 1239: 3655:Center for Global Infectious Disease Research 3141: 244:), which is more sensitive than conventional 8: 2583:(12): e01338–18, /jcm/56/12/e01338–18.atom. 165: 2860:Scandinavian Journal of Infectious Diseases 2406:The Cochrane Database of Systematic Reviews 1297:The Cochrane Database of Systematic Reviews 536:identification of potential biopsy target. 91:, other scans and X-rays, surgical biopsy. 3650:Campaign for Access to Essential Medicines 3148: 3134: 3126: 2287:Gaur RL, Pai M, Banaei N (November 2013). 1629:Akce M, Bonner S, Liu E, Daniel R (2014). 1447:Centers for Disease Control and Prevention 1084:(8th ed.). Saunders Elsevier. pp. 516-522 171: 151:Centers for Disease Control and Prevention 36: 3041: 3031: 2996: 2943: 2831: 2750: 2740: 2699: 2689: 2648: 2596: 2518: 2425: 2353: 2312: 2255: 2172: 2162: 1883: 1656: 1646: 1605: 1518: 1419: 1401: 1324: 1267: 1219: 1127: 1076: 1074: 1072: 1070: 1068: 935:Foundation for Innovative New Diagnostics 755:Persons with no known risk factors for TB 684:CDC classification of tuberculin reaction 472:Tuberculosis creates cavities visible in 139:U.S. Citizenship and Immigration Services 892:Lipoarabinomannan (LAM) detection assays 3521:Extensively drug-resistant tuberculosis 1785:10.7326/0003-4819-146-5-200703060-00006 1064: 447:Acid fast bacilli, Ziehl–Neelsen stain. 389: 292:Nucleic acid amplification tests (NAAT) 3695:International Congress on Tuberculosis 1110:Togun TO, Kampmann B (February 2024). 768:Tuberculin skin test after BCG vaccine 164: 27: 2853: 2851: 2729:The Journal of Clinical Investigation 2618: 2616: 2137:Gaur RL, Suhosk MM, Banaei N (2012). 7: 804:These have been reviewed in detail. 673:0–4 mm induration (Heaf 0 to 1) 554:(from the name of its inventor, Dr. 316:transcription-mediated amplification 300:or gene probe tests can distinguish 21:For an overview of the disease, see 3526:Totally drug-resistant tuberculosis 1586:The New England Journal of Medicine 16:Methods for diagnosing tuberculosis 986:based on the expression levels of 900:(LAM) antigen in urine emerged as 752:15 mm or more is positive in 709:10 mm or more is positive in 360:Mycobacterium tuberculosis complex 177:Distinctive clusters of colorless 79:A complete medical evaluation for 14: 1042:Sokoine University of Agriculture 744:syndromes, low body weight, etc.) 692:5 mm or more is positive in 3690:Global Plan to Stop Tuberculosis 3516:Multidrug-resistant tuberculosis 3259: 2577:Journal of Clinical Microbiology 2342:The European Respiratory Journal 2293:Journal of Clinical Microbiology 2104:The Lancet. Respiratory Medicine 1738:10.1053/j.semnuclmed.2016.12.003 1006:In 2007, a systematic review of 676:5–14 mm induration (Heaf 2) 440: 424: 408: 392: 308:Nucleic acid amplification tests 2629:The Lancet. Infectious Diseases 1547:The Lancet. Infectious Diseases 1169:The Lancet. Infectious Diseases 3349:Interferon gamma release assay 3251:Post-tuberculosis lung disease 2450:randomised controlled trial". 2418:10.1002/14651858.cd011420.pub2 1309:10.1002/14651858.CD012768.pub3 1116:The Lancet Infectious Diseases 721:Mycobacteriology lab personnel 550:A variant of the chest X-Ray, 1: 3857:Respiratory system procedures 3816:Tuberculosis in human culture 3660:Cure Cottages of Saranac Lake 3645:Adirondack Cottage Sanitarium 2641:10.1016/S1473-3099(19)30001-5 2511:10.1016/s0140-6736(18)31267-4 2464:10.1016/s0140-6736(15)01092-2 2257:10.1136/thoraxjnl-2016-209397 2116:10.1016/S2213-2600(16)30436-2 1966:10.1016/S0140-6736(00)05115-1 1922:10.1016/S0140-6736(03)12950-9 1829:10.1016/S0140-6736(06)68579-6 1559:10.1016/S1473-3099(03)00544-9 1181:10.1016/S1473-3099(06)70578-3 1129:10.1016/s1473-3099(23)00517-0 621:Injecting a Mantoux skin test 252:than three gastric washings. 2804:Clinical Infectious Diseases 2691:10.1371/journal.pmed.1003113 2164:10.1371/journal.pone.0048027 1726:Seminars in Nuclear Medicine 1256:Health Technology Assessment 1208:Clinical Infectious Diseases 992:dual-specificity phosphatase 220:, but may also include pus, 3806:Tuberculosis classification 3189:Extrapulmonary tuberculosis 2971:Lalvani A (November 2003). 1996:"The Science behind T-SPOT. 1858:Lalvani A (November 2003). 1773:Annals of Internal Medicine 858:QuantiFERON-TB Gold In-Tube 834:QuantiFERON-TB Gold In-Tube 808:Interferon-γ release assays 493:extrapulmonary tuberculosis 242:auramine-rhodamine staining 135:Tuberculosis classification 3873: 3781:List of tuberculosis cases 3300:Mycobacterium tuberculosis 2214:10.1016/j.jinf.2015.04.004 1403:10.1186/s13568-024-01730-3 1050:African giant pouched rats 929:In 2019, an international 823:Mycobacterium tuberculosis 698:Recent contacts of TB case 651: 610: 596: 543: 456: 213:Mycobacterium tuberculosis 180:Mycobacterium tuberculosis 73:Mycobacterium tuberculosis 20: 3670:Glen Lake Children's Camp 3629:Edward Livingston Trudeau 3569:Friedrich Franz Friedmann 3257: 3246:Giant multinucleated cell 3219:Tuberculous lymphadenitis 2872:10.1080/00365540152029846 2355:10.1183/09031936.00027714 988:guanylate-binding protein 914:World Health Organization 363:(MTBC) and resistance to 312:polymerase chain reaction 170: 35: 3751:Tuberculosis elimination 3330:Löwenstein–Jensen medium 2989:10.1136/thorax.58.11.916 2202:The Journal of Infection 1876:10.1136/thorax.58.11.916 1635:Case Reports in Medicine 491:tuberculosis, a form of 70:is diagnosed by finding 3756:2007 tuberculosis scare 3536:History of tuberculosis 3339:Chest photofluorography 3279:Mycobacterium africanum 3033:10.4103/0970-2113.99112 1082:Robbins Basic Pathology 943:University of Cape Town 904:for tuberculosis (TB). 738:end-stage renal disease 238:fluorescence microscopy 161:Microbiological studies 3831:World Tuberculosis Day 3821:Tuberculosis radiology 3715:National Jewish Health 3311:Tuberculosis diagnosis 3224:Tuberculous meningitis 3173:Pulmonary tuberculosis 921:systematic review and 829:tuberculin skin test. 813:States.For diagnosing 634: 622: 500: 477: 459:Tuberculosis radiology 278:fine needle aspiration 246:Ziehl–Neelsen staining 155:B notification program 31:Tuberculosis diagnosis 3811:Tuberculosis in China 3705:Millennium Foundation 3417:4-Aminosalicylic acid 3324:Auramine phenol stain 3270:Mycobacterium species 3166:associated conditions 3122:) for detection of TB 2901:Law YH (2018-05-16). 2077:10.1378/chest.09-2350 2042:10.1378/chest.06-2805 2014:"How T-SPOT.TB Works" 1503:10.1128/mBio.00812-17 1363:10.1378/chest.06-2959 967:monoclonal antibodies 951:University of Alberta 933:consortium including 652:Further information: 628: 620: 611:Further information: 597:Further information: 544:Further information: 483: 471: 369:drug resistance tests 183:form in this culture. 3761:Baumgarten-Tangl law 3675:Glen Lake Sanatorium 3293:Mycobacterium caprae 3229:Miliary tuberculosis 3204:Canga's bead symptom 3164:Symptoms, signs and 3120:Ocimum Bio Solutions 3014:Nema V (July 2012). 2589:10.1128/JCM.01338-18 2305:10.1128/JCM.01627-13 1700:10.1148/rg.253045115 1598:10.1056/NEJMoa055524 984:polygenic risk score 856:γ in response. The 715:Injection drug users 599:Tuberculin skin test 593:Tuberculin skin test 556:Manuel Dias de Abreu 330:A 2007 before-after 256:Alternative sampling 153:(CDC). The (Class) 128:physical examination 122:Physical examination 89:tuberculin skin test 3725:Stop TB Partnership 3680:Glenn Dale Hospital 3319:Ziehl–Neelsen stain 3286:Mycobacterium bovis 3236:Latent tuberculosis 3109:Spoligo typing kits 2816:10.1093/cid/ciab839 2155:2012PLoSO...748027G 1648:10.1155/2014/436568 1054:Cricetomys ansorgei 1008:adenosine deaminase 1002:Adenosine deaminase 996:Krüppel-like factor 902:point-of-care tests 788:latent tuberculosis 695:HIV-positive person 588:Immunological tests 332:observational study 314:(PCR) technique or 167: 3579:Philip D'Arcy Hart 3114:2012-01-09 at the 2945:10.1038/pr.2018.40 2932:Pediatric Research 2779:clinicaltrials.gov 2505:(10144): 292–301. 2458:(10024): 1187–97. 1032:Using trained rats 947:Rutgers University 846:interferon γ tests 819:systematic reviews 775:interferon-γ tests 635: 623: 501: 478: 464:Chest X-ray and CT 232:Sputum smears and 3839: 3838: 3344:GeneXpert MTB/RIF 2810:(12): 2136–2141. 2742:10.1172/JCI140461 2735:(11): 5756–5764. 1960:(9273): 2017–21. 1916:(9364): 1168–73. 1823:(9519): 1328–34. 1090:978-1-4160-2973-1 1040:was working with 1019:Transdermal Patch 980:Cepheid (company) 898:lipoarabinomannan 607:Mantoux skin test 381:Löwenstein-Jensen 208: 207: 149:developed by the 65: 64: 3864: 3609:Mario Raviglione 3263: 3209:Prosector's wart 3194:Caseous necrosis 3150: 3143: 3136: 3127: 3055: 3045: 3035: 3010: 3000: 2958: 2957: 2947: 2923: 2917: 2916: 2914: 2913: 2898: 2892: 2891: 2855: 2846: 2845: 2835: 2795: 2789: 2788: 2786: 2785: 2771: 2765: 2764: 2754: 2744: 2720: 2714: 2713: 2703: 2693: 2669: 2663: 2662: 2652: 2620: 2611: 2610: 2600: 2568: 2562: 2561: 2559: 2558: 2549:. Archived from 2539: 2533: 2532: 2522: 2490: 2484: 2483: 2446: 2440: 2439: 2429: 2397: 2391: 2390: 2388: 2387: 2382: 2374: 2368: 2367: 2357: 2333: 2327: 2326: 2316: 2284: 2278: 2277: 2259: 2241: 2232: 2226: 2225: 2193: 2187: 2186: 2176: 2166: 2134: 2128: 2127: 2095: 2089: 2088: 2060: 2054: 2053: 2024: 2018: 2017: 2010: 2004: 2003: 1992: 1986: 1985: 1948: 1942: 1941: 1904: 1898: 1897: 1887: 1855: 1849: 1848: 1811: 1805: 1804: 1768: 1762: 1756: 1750: 1749: 1721: 1712: 1711: 1683: 1674: 1670: 1660: 1650: 1626: 1620: 1619: 1609: 1577: 1571: 1570: 1542: 1533: 1532: 1522: 1482: 1476: 1475: 1473: 1472: 1466: 1460:, archived from 1455: 1443: 1434: 1433: 1423: 1405: 1381: 1375: 1374: 1345: 1339: 1338: 1328: 1288: 1282: 1281: 1271: 1269:10.3310/hta11030 1247: 1234: 1233: 1223: 1199: 1193: 1192: 1164: 1158: 1157: 1131: 1107: 1101: 1098: 1092: 1078: 832:The blood tests 780:QuantiFERON Gold 525:tree-in-bud sign 521:tree-in-bud sign 510:immunosuppressed 444: 428: 412: 396: 262:gastric washings 175: 168: 40: 28: 3872: 3871: 3867: 3866: 3865: 3863: 3862: 3861: 3842: 3841: 3840: 3835: 3826:Tygerberg score 3739: 3633: 3599:Charles Mantoux 3589:George M. Heath 3559:Christopher Dye 3554:Albert Calmette 3549:Hermann Brehmer 3544:Manuel de Abreu 3530: 3504: 3466: 3400: 3392: 3305: 3264: 3255: 3165: 3159: 3154: 3116:Wayback Machine 3095: 3063: 3058: 3013: 2970: 2966: 2964:Further reading 2961: 2925: 2924: 2920: 2911: 2909: 2900: 2899: 2895: 2857: 2856: 2849: 2797: 2796: 2792: 2783: 2781: 2773: 2772: 2768: 2722: 2721: 2717: 2684:(5): e1003113. 2671: 2670: 2666: 2622: 2621: 2614: 2570: 2569: 2565: 2556: 2554: 2541: 2540: 2536: 2492: 2491: 2487: 2448: 2447: 2443: 2412:(5): CD011420. 2399: 2398: 2394: 2385: 2383: 2380: 2376: 2375: 2371: 2335: 2334: 2330: 2286: 2285: 2281: 2250:(10): 946–949. 2239: 2234: 2233: 2229: 2195: 2194: 2190: 2136: 2135: 2131: 2097: 2096: 2092: 2062: 2061: 2057: 2026: 2025: 2021: 2012: 2011: 2007: 1994: 1993: 1989: 1950: 1949: 1945: 1906: 1905: 1901: 1857: 1856: 1852: 1813: 1812: 1808: 1770: 1769: 1765: 1757: 1753: 1723: 1722: 1715: 1685: 1684: 1677: 1628: 1627: 1623: 1592:(15): 1539–50. 1579: 1578: 1574: 1544: 1543: 1536: 1484: 1483: 1479: 1470: 1468: 1464: 1453: 1445: 1444: 1437: 1383: 1382: 1378: 1347: 1346: 1342: 1303:(1): CD012768. 1290: 1289: 1285: 1249: 1248: 1237: 1214:(11): 1415–20. 1201: 1200: 1196: 1166: 1165: 1161: 1109: 1108: 1104: 1099: 1095: 1079: 1066: 1062: 1034: 1021: 1004: 976: 894: 810: 770: 686: 656: 650: 615: 609: 601: 595: 590: 548: 542: 533: 466: 461: 455: 448: 445: 436: 429: 420: 413: 404: 397: 377: 302:M. tuberculosis 294: 282:mediastinoscopy 258: 230: 184: 163: 124: 97: 95:Medical history 53: 43:M. tuberculosis 26: 17: 12: 11: 5: 3870: 3868: 3860: 3859: 3854: 3844: 3843: 3837: 3836: 3834: 3833: 3828: 3823: 3818: 3813: 3808: 3803: 3798: 3793: 3788: 3783: 3778: 3773: 3768: 3763: 3758: 3753: 3747: 3745: 3741: 3740: 3738: 3737: 3732: 3727: 3722: 3717: 3712: 3707: 3702: 3697: 3692: 3687: 3682: 3677: 3672: 3667: 3662: 3657: 3652: 3647: 3641: 3639: 3635: 3634: 3632: 3631: 3626: 3621: 3616: 3611: 3606: 3604:Richard Morton 3601: 3596: 3591: 3586: 3581: 3576: 3571: 3566: 3564:Marcos Espinal 3561: 3556: 3551: 3546: 3540: 3538: 3532: 3531: 3529: 3528: 3523: 3518: 3512: 3510: 3506: 3505: 3503: 3502: 3501: 3500: 3495: 3490: 3482: 3476: 3474: 3468: 3467: 3465: 3464: 3459: 3454: 3449: 3444: 3439: 3434: 3429: 3424: 3419: 3414: 3408: 3406: 3394: 3393: 3391: 3390: 3389: 3388: 3383: 3378: 3368: 3363: 3362: 3361: 3356: 3346: 3341: 3336: 3326: 3321: 3315: 3313: 3307: 3306: 3304: 3303: 3296: 3289: 3282: 3274: 3272: 3266: 3265: 3258: 3256: 3254: 3253: 3248: 3243: 3238: 3233: 3232: 3231: 3226: 3221: 3216: 3214:Lupus vulgaris 3211: 3206: 3201: 3196: 3186: 3185: 3184: 3182:Ghon's complex 3169: 3167: 3161: 3160: 3155: 3153: 3152: 3145: 3138: 3130: 3124: 3123: 3106: 3101: 3094: 3093:External links 3091: 3090: 3089: 3076:2000 ATS/CDC ( 3071: 3062: 3059: 3057: 3056: 3011: 2967: 2965: 2962: 2960: 2959: 2918: 2893: 2847: 2790: 2766: 2715: 2664: 2635:(8): 852–861. 2612: 2563: 2534: 2485: 2441: 2392: 2369: 2328: 2299:(11): 3521–6. 2279: 2227: 2188: 2149:(10): e48027. 2129: 2110:(4): 259–268. 2090: 2055: 2019: 2005: 1987: 1943: 1899: 1850: 1806: 1763: 1751: 1732:(3): 304–318. 1713: 1694:(3): 789–801. 1675: 1621: 1572: 1534: 1477: 1435: 1376: 1340: 1283: 1235: 1221:10.1086/516782 1194: 1159: 1122:(2): 110–112. 1102: 1093: 1063: 1061: 1058: 1033: 1030: 1025:M.tuberculosis 1020: 1017: 1003: 1000: 975: 972: 893: 890: 809: 806: 802: 801: 798: 795: 769: 766: 762: 761: 760: 759: 756: 750: 749: 748: 745: 730:corticosteroid 722: 719: 716: 713: 707: 706: 705: 702: 699: 696: 685: 682: 681: 680: 677: 674: 649: 646: 608: 605: 594: 591: 589: 586: 541: 538: 532: 529: 465: 462: 457:Main article: 454: 451: 450: 449: 446: 439: 437: 430: 423: 421: 414: 407: 405: 398: 391: 376: 373: 293: 290: 257: 254: 229: 226: 206: 205: 202: 196: 195: 192: 186: 185: 176: 162: 159: 123: 120: 96: 93: 63: 62: 59: 55: 54: 41: 33: 32: 15: 13: 10: 9: 6: 4: 3: 2: 3869: 3858: 3855: 3853: 3850: 3849: 3847: 3832: 3829: 3827: 3824: 3822: 3819: 3817: 3814: 3812: 3809: 3807: 3804: 3802: 3799: 3797: 3794: 3792: 3789: 3787: 3784: 3782: 3779: 3777: 3774: 3772: 3769: 3767: 3764: 3762: 3759: 3757: 3754: 3752: 3749: 3748: 3746: 3742: 3736: 3733: 3731: 3728: 3726: 3723: 3721: 3718: 3716: 3713: 3711: 3708: 3706: 3703: 3701: 3698: 3696: 3693: 3691: 3688: 3686: 3683: 3681: 3678: 3676: 3673: 3671: 3668: 3666: 3663: 3661: 3658: 3656: 3653: 3651: 3648: 3646: 3643: 3642: 3640: 3638:Organizations 3636: 3630: 3627: 3625: 3622: 3620: 3617: 3615: 3612: 3610: 3607: 3605: 3602: 3600: 3597: 3595: 3592: 3590: 3587: 3585: 3584:F. 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Heaf 3582: 3580: 3577: 3575: 3572: 3570: 3567: 3565: 3562: 3560: 3557: 3555: 3552: 3550: 3547: 3545: 3542: 3541: 3539: 3537: 3533: 3527: 3524: 3522: 3519: 3517: 3514: 3513: 3511: 3507: 3499: 3496: 3494: 3491: 3489: 3486: 3485: 3484:Experimental 3483: 3481: 3478: 3477: 3475: 3473: 3469: 3463: 3460: 3458: 3455: 3453: 3450: 3448: 3445: 3443: 3442:Thioacetazone 3440: 3438: 3435: 3433: 3430: 3428: 3425: 3423: 3420: 3418: 3415: 3413: 3410: 3409: 3407: 3404: 3399: 3395: 3387: 3384: 3382: 3379: 3377: 3374: 3373: 3372: 3369: 3367: 3364: 3360: 3357: 3355: 3352: 3351: 3350: 3347: 3345: 3342: 3340: 3337: 3335: 3331: 3327: 3325: 3322: 3320: 3317: 3316: 3314: 3312: 3308: 3302: 3301: 3297: 3295: 3294: 3290: 3288: 3287: 3283: 3281: 3280: 3276: 3275: 3273: 3271: 3267: 3262: 3252: 3249: 3247: 3244: 3242: 3239: 3237: 3234: 3230: 3227: 3225: 3222: 3220: 3217: 3215: 3212: 3210: 3207: 3205: 3202: 3200: 3197: 3195: 3192: 3191: 3190: 3187: 3183: 3179: 3176: 3175: 3174: 3171: 3170: 3168: 3162: 3158: 3151: 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