Performance of Xpert MTB/RIF Ultra for tuberculosis diagnosis in the context of passive and active case finding
| Autor: | Adrià Murias-Closas, Sozinho Acácio, Laura Oliveras, Grant Theron, Alberto L. García-Basteiro, Irene Losada, Hadrian Pernas, Neide Gomes, Shilzia Munguane, Edson Mambuque, Belén Saavedra, Marta Cossa, Juan Ignacio García, Dinis Nguenha, Santiago Izco |
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| Rok vydání: | 2021 |
| Předmět: |
Pulmonary and Respiratory Medicine
Adult medicine.medical_specialty business.industry Diagnostic Tests Routine Human immunodeficiency virus (HIV) Sputum Diagnostic accuracy Context (language use) Mycobacterium tuberculosis medicine.disease_cause Sensitivity and Specificity Smear microscopy Tuberculosis diagnosis Internal medicine Cohort medicine Case finding Humans Tuberculosis Previously treated business Tuberculosis Pulmonary |
| Zdroj: | The European respiratory journal. 58(6) |
| ISSN: | 1399-3003 |
| Popis: | AimsWe present a field evaluation of the diagnostic accuracy of Xpert MTB/RIF (“Xpert”) and Xpert MTB/RIF Ultra (“Ultra”) using two cohorts in a high tuberculosis/HIV burden setting in Southern Mozambique.MethodsSingle respiratory specimens from symptomatic adults accessing healthcare services (passive case finding (PCF) cohort) and from household and community close contacts (active case finding (ACF) cohort) were tested by smear microscopy, culture, Xpert and Ultra. Liquid and solid culture served as a composite reference standard. We explored the impact of trace results on specificity via their recategorisation to negative (in all and just among those previously treated individuals).Results1419 and 252 participants were enrolled in the PCF and ACF cohorts, respectively. For the PCF cohort, Ultra showed higher sensitivity than Xpert overall (0.95 (95% CI 0.90–0.98) versus 0.88 (96% CI 0.82–0.93); pversus 0.63 (96% CI 0.48–0.76)). Ultra's specificity was lower than Xpert's (0.96 (96% CI 0.95–0.97) versus 0.98 (96% CI 0.97–0.99); p=0.008). For ACF, sensitivities were the same (0.67 (95% CI 0.22–0.96) for both tests), although Ultra detected a higher number of microbiologically confirmed samples than Xpert (4.7% (12 out of 252) versus 2.7% (seven out of 252)). Conditional recategorisation of trace results among previously treated participants maintained differences in specificity in the PCF cohort.ConclusionThese results add evidence on the improved sensitivity of Ultra and support its use in different case finding scenarios. |
| Databáze: | OpenAIRE |
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