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Routine use of Xpert((R)) MTB/RIF in areas with different prevalences of HIV and drug-resistant tuberculosis

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dc.contributor.author Page, A. L.
dc.contributor.author Ardizzoni, E.
dc.contributor.author Lassovsky, M.
dc.contributor.author Kirubi, B.
dc.contributor.author Bichkova, D.
dc.contributor.author Pedrotta, A.
dc.contributor.author Lastrucci, C.
dc.contributor.author de la Tour, R.
dc.contributor.author Bonnet, M.
dc.contributor.author Varaine, F.
dc.date.accessioned 2016-02-04T09:25:54Z
dc.date.available 2016-02-04T09:25:54Z
dc.date.issued 2015
dc.identifier.issn 1027-3719
dc.identifier.doi http://dx.doi.org/10.5588/ijtld.14.0951
dc.identifier.other ITG-B2B
dc.identifier.other DBM
dc.identifier.other U-MYCOB
dc.identifier.other JIF
dc.identifier.other DOI
dc.identifier.other Abstract
dc.identifier.other UPD60
dc.identifier.uri http://hdl.handle.net/10390/8661
dc.description.abstract SETTING: Despite the widespread introduction of Xpert((R)) MTB/RIF in developing countries, reports of its use and value in routine conditions remain limited. OBJECTIVE: To describe Xpert results in relation to microscopy, treatment initiation, cost and workload under routine conditions at four sites in Cambodia, Georgia, Kenya and Swaziland. DESIGN: Laboratory and clinical information on presumed TB patients were obtained from routine registers over a period of at least 6 months between March and November 2012. RESULTS: Among the 6086 presumed TB patients included in the analysis, Xpert testing increased the number of biologically confirmed cases by 15% to 67% compared to microscopy. Up to 12% of the initial Xpert results were inconclusive. Between 56% and 83% of patients were started on treatment based on microscopy and/or Xpert results, with median delays of 1-16 days. Rifampicin resistance was detected in 3-19% of Xpert-positive patients. CONCLUSION: Despite the additional numbers of cases detected by Xpert compared to microscopy, large proportions of patients are still started on treatment empirically in routine practice. Patient and specimen flow should be optimised to reduce delays in treatment initiation. Simple, non-sputum-based point-of-care tests with high sensitivity are needed to improve TB diagnosis and management. en_US
dc.language English en_US
dc.subject Bacterial diseases en_US
dc.subject Tuberculosis en_US
dc.subject Mycobacterium tuberculosis en_US
dc.subject Viral diseases en_US
dc.subject HIV en_US
dc.subject AIDS en_US
dc.subject Prevalence en_US
dc.subject Rapid diagnostic tests en_US
dc.subject Drug resistance en_US
dc.subject Case detection en_US
dc.subject Microscopy en_US
dc.subject Cost en_US
dc.subject Workload en_US
dc.subject Rifampicin en_US
dc.subject Delay en_US
dc.subject Cambodia en_US
dc.subject Asia, Southeast en_US
dc.subject Georgia en_US
dc.subject Asia, Central en_US
dc.subject Kenya en_US
dc.subject Africa, East en_US
dc.subject Swaziland en_US
dc.subject Africa, Southern en_US
dc.title Routine use of Xpert((R)) MTB/RIF in areas with different prevalences of HIV and drug-resistant tuberculosis en_US
dc.type Article en_US
dc.citation.issue 9 en_US
dc.citation.jtitle International Journal of Tuberculosis and Lung Disease en_US
dc.citation.volume 19 en_US
dc.citation.pages 1078- 1083 en_US
dc.identifier.pmid http://www.ncbi.nlm.nih.gov/pubmed/26260829
dc.citation.jabbreviation Int J Tuberc Lung Dis en_US


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