Diagnosis of tuberculosis through breath test: A systematic review

EBioMedicine. 2019 Aug:46:202-214. doi: 10.1016/j.ebiom.2019.07.056. Epub 2019 Aug 8.

Abstract

Background: Breath tests may diagnose tuberculosis (TB) through detecting specific volatile organic compounds produced by Mycobacterium tuberculosis or the infected host.

Methods: To estimate the diagnostic accuracy of breath test with electronic-nose and other devices against culture or other tests for TB, we screened multiple databases until January 6, 2019.

Findings: We included fourteen studies, with 1715 subjects in the analysis. The pooled sensitivity and specificity of electronic-nose were 0.93 (95% CI 0.82-0.97) and 0.93 (95% CI 0.82-0.97), respectively, and no heterogeneity was found. The sensitivity and specificity of other breath test devices ranged from 0.62 to 1.00, and 0.11 to 0.84, respectively.

Interpretation: The low to moderate evidence of these studies shows that breath tests can diagnose TB accurately, however, to give a real-time test result, additional development is needed. Research should also focus on sputum smear negative TB, children, and the positioning of breath testing in the diagnostic work flow.

Funding: The authors received no specific funding for this work.

Keywords: Accuracy; Breath test; Diagnosis; Sensitivity; Specificity; Tuberculosis.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Biosensing Techniques / instrumentation
  • Biosensing Techniques / methods
  • Breath Tests / instrumentation
  • Breath Tests / methods*
  • Electronic Nose
  • Female
  • Humans
  • Male
  • Mycobacterium tuberculosis / metabolism
  • ROC Curve
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Tuberculosis / diagnosis*
  • Tuberculosis / metabolism
  • Tuberculosis / microbiology
  • Tuberculosis, Pulmonary / diagnosis
  • Tuberculosis, Pulmonary / microbiology
  • Volatile Organic Compounds / analysis
  • Volatile Organic Compounds / metabolism

Substances

  • Volatile Organic Compounds