Point of care testing evaluation of lateral flow immunoassay for diagnosis of cryptococcus meningitis in HIV-positive patients at an urban hospital in Nairobi, Kenya, 2017

OBJECTIVES: The objective of this study was to evaluate the performance of lateral flow immunoassay (LFA) against latex agglutination (LA), India ink and culture in point-of-care diagnosis of cryptococcus meningitis (CM). We conducted cross-sectional study among HIV-positive patients with suspected CM at Mbagathi Hospital, Nairobi, April-July 2017. RESULTS: Of 124 capillary blood and serum and 99 cerebrospinal fluid (CSF) samples, LFA and LA had a concurrence on serum of 94.4%, kappa (0.88), sensitivity (100%) and specificity (91%). LFA and LA on CSF, was 97.9%, kappa (0.96), sensitivity (100%) and specificity (96%). LFA and India ink was 96.9%, kappa (0.94), sensitivity (100%) and specificity (94.1%). On CSF culture, concurrence was 72.7%, kappa (0.43), sensitivity (100%) and specificity (64%) and of LFA on capillary blood, serum and CSF was 100% with kappa (1.00), sensitivity and specificity of 100%.