Routine use of Xpert® MTB/RIF in areas with different prevalences of HIV and drug-resistant tuberculosis
| Autor: | Francis Varaine, Anne-Laure Page, M. Lassovsky, D. Bichkova, A. Pedrotta, C. Lastrucci, B. Kirubi, Maryline Bonnet, Elisa Ardizzoni, R. de la Tour |
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| Rok vydání: | 2015 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Tuberculosis biology business.industry Drug resistant tuberculosis Human immunodeficiency virus (HIV) Drug resistance medicine.disease_cause medicine.disease biology.organism_classification Surgery Mycobacterium tuberculosis Infectious Diseases Acquired immunodeficiency syndrome (AIDS) Internal medicine medicine Sputum medicine.symptom business Rifampicin medicine.drug |
| Zdroj: | The International Journal of Tuberculosis and Lung Disease. 19:1078-1083 |
| ISSN: | 1815-7920 1027-3719 |
| DOI: | 10.5588/ijtld.14.0951 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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