Details:

Alternative Title:
Pan Afr Med J
Personal Author:
Zimba, Onani ; Tamuhla, Tsaone ; Basotli, Joyce ; Letsibogo, Gaoraelwe ; Pals, Sherri ; ... More +
Zimba, Onani ; Tamuhla, Tsaone ; Basotli, Joyce ; Letsibogo, Gaoraelwe ; Pals, Sherri ; Mathebula, Unami ; Mathoma, Anikie ; Serumola, Christopher ; Ramogale, Kitso ; Boyd, Rosanna ; Tran, Tiffany ; Finlay, Alyssa ; Auld, Andrew ; Date, Anand ; Alexander, Heather ; Chihota, Violet ; Agizew, Tefera Less -
Description:
Introduction

The World Health Organization endorsed (2010) the use of Xpert MTB/RIF and countries are shifting from smear microscopy (smear)-based to Xpert MTB/RIF-based tuberculosis (TB) diagnostic algorithms. As with smear, sputum quality may predict the likelihood of obtaining a bacteriologically-confirmed TB when using Xpert MTB/RIF.

Methods

From 08/12-11/2014, all people living with HIV were recruited at 22 clinics. For patients screened positive using the four TB symptoms their sputa were tested by Xpert MTB/RIF and smear. Laboratorians assessed and recorded sputum appearance and volume. The yield of bacteriologically-positive sputum evaluated using Xpert MTB/RIF and smear, likelihood-ratios were calculated.

Results

Among 6,041 patients enrolled 2,296 were presumptive TB, 1,305 (56.8%) had > 1 sputa collected and 644/1,305 (49.3%) had both Xpert MTB/RIF and smear results. Since >1 sputa collected from 644 patients 954 sputa were tested by Xpert MTB/RIF and smear. Bacteriologically-positive sputum was two-fold higher with Xpert MTB/RIF 11.4% versus smear 5.3%, p < 0.001. Sputum appearance and quantity were not predictive of bacteriologically-positive results, except volume of 2ml to < 3ml, tested by Xpert MTB/RIF LR+= 1.26 (95% CI, 1.05–1.50).

Conclusion

Xpert MTB/RIF test yield to bacteriologically-positive sputum was superior to smear. Sputum quality and quantity, however, were not consistently predictive of bacteriologically-positive results by Xpert MTB/RIF or smear.


Subjects:
[+]
Adult Bacteriological Techniques Female Follow-Up Studies Humans Male Microscopy Molecular Diagnostic Techniques Prospective Studies Sputum Tuberculosis
Source:
Pan Afr Med J. 2019; 33
Pubmed ID:
31489088
Pubmed Central ID:
PMC6711687
Document Type:
Journal Article
Place as Subject:
Botswana
Location:
Africa
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:b5f97fa51c9bb3e1e5bff44e532dea1390bec72289342f056a730d0a4802958d
Download URL:
https://stacks.cdc.gov/view/cdc/82539/cdc_82539_DS1.pdf
File Type:

Supporting Files

• 	PAMJ-33-110-g001.gif	gif
  	PAMJ-33-110-g001.jpg	jpeg
  	PAMJ-33-110-g002.gif	gif
  	PAMJ-33-110-g002.jpg	jpeg
  	PAMJ-33-110.nxml	xml

More +