Correction: Implementation Research to Inform the Use of Xpert MTB/RIF in Primary Health Care Facilities in High TB and HIV Settings in Resource Constrained Settings

Muyoyeta, Monde; Moyo, Maureen; Kasese, Nkatya; Ndhlovu, Mapopa; Milimo, Deborah; Mwanza, Winfridah; Kapata, Nathan; Schaap, Albertus; Faussett, Peter Godfrey; Ayles, Helen

doi:10.1371/journal.pone.0137934

Cited by 10 publications

(1 citation statement)

References 2 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…O risco das pessoas que vivem com HIV/aids de adquirir TB é de 10% ao ano, já para indivíduos que não estão infectados pelo vírus, o mesmo percentual refere-se à possibilidade da população em geral adoecer por TB ao longo da vida. 15 Neste sentido, é essencial a detecção precoce dos casos coinfectados TB/ HIV para que seja iniciado o uso dos medicamentos contra a TB, bem como antirretrovirais, visando a prevenção, interrupção da cadeia de transmissão, complicações e a morbimortalidade. 15 Porto Velho destaca-se como a segunda capital do país com a maior percentual de abandono, o que demonstra consequentemente uma baixa taxa de cura,…”

Section: Discussionunclassified

Perfil epidemiológico da tuberculose no serviço de referência do estado de Rondônia

Silva

Felipini

Oliveira

et al. 2019

Rev Epidemiol Control Infect

View full text Add to dashboard Cite

Justificativa e Objetivo: Apesar da Atenção Primária à Saúde (APS) configurar-se como coordenadora e ordenadora do cuidado, grande parte do diagnóstico da tuberculose (TB) é realizado nas unidades de Pronto-Atendimento e serviços de referência. Neste sentido, este estudo teve como objetivo analisar os casos de TB que foram diagnosticados e notificados no serviço de referência do estado de Rondônia no período de 2014 a 2016. Métodos: Trata-se de um estudo descritivo, do tipo transversal e abordagem quantitativa. Os dados foram coletados por meio de um levantamento das variáveis sociodemográficas e clínicas no SINAN e analisado por meio da estatística descritiva, após atender os preceitos éticos. Resultados: No período estudado, foram diagnosticados e notificados 2.230 casos de TB em Rondônia, dos quais 67,40% foram em Porto Velho, e destes 50,30% no serviço de referência. No que concerne ao perfil, verificou-se que a média de idade foi de 38 anos (±16), sendo a maioria do sexo masculino, raça/cor parda, com menos de 8 anos de escolaridade, residia em Porto Velho, zona urbana, caso novo, forma clínica pulmonar, baciloscopia de escarro positiva, radiografia de tórax suspeito de TB, HIV negativo e cultura de escarro não realizada. Observou-se baixa taxa de cura e elevada para transferência e abandono. O tempo médio de tratamento foi de 160 dias (±103). Conclusão: Tais achados são semelhantes com a literatura, o que demonstra a fragilidade da APS em relação as ações estratégicas para detecção precoce, tratamento oportuno e acompanhamento dos casos de TB. Descritores: Tuberculose Pulmonar. Diagnóstico. Serviços de Saúde. Atenção Terciária à Saúde.

show abstract

Section: Discussionunclassified

Perfil epidemiológico da tuberculose no serviço de referência do estado de Rondônia

Silva

Felipini

Oliveira

et al. 2019

Rev Epidemiol Control Infect

View full text Add to dashboard Cite

show abstract

The Performance of Computer-Aided Detection Digital Chest X-ray Reading Technologies for Triage of Active Tuberculosis Among Persons With a History of Previous Tuberculosis

Kagujje

Kerkhoff

Nteeni

et al. 2022

Clinical Infectious Diseases

View full text Add to dashboard Cite

Background Digital Chest X-ray (dCXR) computer-aided detection (CAD) technology uses lung shape and texture analysis to determine the probability of TB. However, many patients with previously treated TB have sequelae, which also distort lung shape and texture. We evaluated the diagnostic performance of two CAD systems for triage of active TB in patients with previously treated TB. Methods We conducted a retrospective analysis of data from a cross-sectional active TB case finding study. Participants ≥15 years, with ≥1 current TB symptom, and with complete data on history of previous TB, dCXR, and TB microbiological reference (Xpert MTB/RIF) were included. dCXRs were evaluated using CAD4TB (v.7.0) and qXR (v.3.0). We determined the diagnostic accuracy of both systems, overall and stratified by history of TB, using a single threshold for each system that achieved 90% sensitivity and maximized specificity in the overall population. Results Of 1,884 participants, 452 (24.0%) had a history of previous TB. The prevalence of microbiologically confirmed TB among those with and without history of previous TB was 12.4% and 16.9% respectively. Using CAD4TB, the sensitivity and specificity was 89.3% (95%CI:78.1-96.0) and 24.0% (95%CI19.9-28.5) and 90.5% (95%CI:86.1-93.3) and 60.3% (95%CI:57.4-63.0) among those with and without previous TB, respectively. Using qXR, the sensitivity and specificity was 94.6% (95%CI:85.1-98.9) and 22.2% (95%CI:18.2-26.6) and 89.7% (95%CI:85.1-93.2) and 61.8% (95%CI:58.9-64.5) among those with and without previous TB, respectively. Conclusion The performance of CAD systems as a TB triage tool is decreased among persons previously treated for TB.

show abstract

Impact of Point-of-Care Xpert MTB/RIF on Tuberculosis Treatment Initiation. A Cluster-randomized Trial

Lessells

Cooke

McGrath

et al. 2017

Am J Respir Crit Care Med

View full text Add to dashboard Cite

Scientific Knowledge on the SubjectCentralised laboratory-based diagnostic systems for tuberculosis are associated with substantial loss to follow-up and delays prior to treatment. Whether decentralised, point-of-care diagnostic systems can reduce loss to follow-up and treatment delay has not been adequately investigated. What This Study Adds to the FieldThis is the first randomised trial to make a direct comparison between point-of-care and laboratory use of a molecular TB diagnostic. The point-of-care strategy shortened the time to appropriate treatment for people with rifampicin-susceptible TB; three-quarters of Xpert-positive/rifampicinsusceptible cases received same-day diagnosis and treatment. Under both strategies, there were delays for people with drug-resistant TB and people with Xpert-negative/culture-positive TB, highlighting the need for more sensitive rapid diagnostics and further strengthening of health and laboratory systems.This article has an online data supplement, which is accessible from this issue's table of content online at www.atsjournals.org Objective: To evaluate the effect of a POC diagnostic strategy on initiation of appropriate TB treatment. Methods:A cluster randomised trial of adults with cough who were HIV positive and/or at high risk of drug-resistant TB. Two-week time blocks were randomised to two strategies (i) Xpert performed at district hospital laboratory (ii) POC Xpert performed at primary health care clinic.All participants provided two sputum specimens: one for Xpert and the other for culture as reference standard. The primary outcome was the proportion of culture-positive pulmonary TB (PTB) cases initiated on appropriate TB treatment within 30 days. Measurements and Main IntroductionTuberculosis (TB) remains one of the most important causes of global mortality, causing around 5000 deaths every day (1). In sub-Saharan Africa, the human immunodeficiency virus (HIV) epidemic and the spread of drug-resistant TB (DR-TB) contributed to a failure to achieve targets for reduction in TB prevalence and mortality in the United Nations Millennium Development Goals (MDG) (2). Timely detection and treatment of adult pulmonary TB cases is important, not only to limit individual morbidity and mortality but also to interrupt transmission. Centralised laboratory-based TB diagnostic systems are associated with substantial loss to follow-up and delays prior to treatment (3, 4). While diagnostics with improved sensitivity for detecting TB disease could have substantial clinical and public health impact, additional benefit might be achieved by positioning diagnostics at more peripheral levels of the health system (5, 6), however, there is little high quality evidence as to whether implementation of diagnostics at the point of care (POC) improves patient-relevant outcomes.This evidence is important to inform the scale-up of existing technologies and to guide the development of new diagnostics (7, 8). The aim of this trial was to determine whether a diagnostic strategy involving a rapid mol...

show abstract

Correction: Implementation Research to Inform the Use of Xpert MTB/RIF in Primary Health Care Facilities in High TB and HIV Settings in Resource Constrained Settings

Cited by 10 publications

References 2 publications

Perfil epidemiológico da tuberculose no serviço de referência do estado de Rondônia

Perfil epidemiológico da tuberculose no serviço de referência do estado de Rondônia

The Performance of Computer-Aided Detection Digital Chest X-ray Reading Technologies for Triage of Active Tuberculosis Among Persons With a History of Previous Tuberculosis

Impact of Point-of-Care Xpert MTB/RIF on Tuberculosis Treatment Initiation. A Cluster-randomized Trial

Contact Info

Product

Resources

About