While tuberculosis (TB) is the top killer of people living with HIV, TB is also harder to diagnose in people living with HIV than in people who are not. What is more, TB is particularly difficult to diagnose in people living with HIV who have compromised immune systems.
Imagine, for example, someone living with HIV is very sick and lying in hospital. It is not known whether or not the person has TB. They may not be coughing much and may be unable to cough up the sputum required for the standard molecular TB test, a test that takes at least a few hours to do.
This is where the urinary LAM (or ULAM) test can make all the difference. Much like a pregnancy test, all that is required is a urine sample and the test kit. It takes 25 minutes to get a result. If a diagnosis is confirmed, the patient can immediately be started on TB treatment.
Yet, while the case for using ULAM in such circumstances is compelling, the World Health Organization (WHO) first recommended its use in 2015, and uptake of the test in South Africa has been slow. But, based on presentations at the 7th South African TB Conference recently held in Durban, use of the test is now increasing. The WHO published an expanded recommendation for ULAM in 2019.
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