Early chest X-ray in persons with presumptive tuberculosis increases Xpert® MTB/RIF diagnostic yield and efficiency

Nadiah, Zahra; Koesoemadinata, Raspati C; McAllister, Susan; Putriyani, G.; Chaidir, Lidya; Ruslami, Rovina; Santoso, Prayudi; Hill, Philip C.; Crevel, Reinout van; Alisjahbana, Bachti

doi:10.5588/pha.19.0052

Cited by 5 publications

(5 citation statements)

References 5 publications

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“…Also, the TB prevalence among presumptive in this study was similar to the 21% reported from Aba prison in Abia state Nigeria [12] but higher than 9% from Ethiopia [6]. However, these related studies used a symptombased ACF model, which is associated with more number of missed cases when compared to the CAD4TB chest X-ray used in this project [21]. Furthermore, Xpert testing used for this study is superior to sputum microscopy for the diagnosis of TB [21].…”

Section: Discussionsupporting

confidence: 68%

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Outcome of Tuberculosis Case Surveillance at Kano Central Correctional Center, North-west Nigeria: A Need for Routine Active Case Findings for TB in Nigerian Correctional Centers

Tukur¹,

Odume²,

Bajehson³

et al. 2021

IJTDH

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Aim: To demonstrate the need for routine active TB case finding in Nigerian correctional centers through a TB case surveillance intervention at the largest correctional centre in the most populous state in Nigeria by KNCV Tuberculosis Foundation Nigeria. Study Design: It was a retrospective review of public health intervention data derived from the mass TB screening of Kano central correctional centre inmates in Kano state, Nigeria. Methodology: A digital X-ray with artificial intelligence (AI) was used for mass TB screening of 1,967 consenting inmates at the Kano central correctional centre in Kano state, Nigeria, from 21st September to 2nd October 2020. Participants with CAD4TB score ≥ 60 had a GeneXpert assessment of their sputa for TB diagnosis. Where sputum production was not possible, or GeneXpert result was negative, expert clinical evaluation of the presumptive radiogram was carried out by experienced radiologist. Data from the project were extracted and analysed for this report. Proportions and means were compared with Fisher Exact test and Student t-test, respectively. A p-value of < 0.05 was considered statistically significant. Results: Overall, 1,967 inmates were screened for TB and 92 (4.7%) presumptive were identified - males (4.8%, 91/92), females (1.9%, 1/92). Out of the 92 presumptive, 21 males were diagnosed as TB cases giving a TB prevalence of 1.1% among the inmates and 22.8% among presumptive. One of the TB cases had multi-drug resistant TB. The number needed to screen (NNS) was 94. All TB cases were enrolled in treatment. Conclusion: The prevalence of TB at the Kano central correctional centre during the mass TB screening project was high. The National Tuberculosis Control Programme of Nigeria should accelerate the planned paradigm shift from passive to active case-finding for TB in Nigerian correctional centers.

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Section: Discussionsupporting

confidence: 68%

“…However, these related studies used a symptombased ACF model, which is associated with more number of missed cases when compared to the CAD4TB chest X-ray used in this project [21]. Furthermore, Xpert testing used for this study is superior to sputum microscopy for the diagnosis of TB [21].…”

Section: Discussionmentioning

confidence: 99%

Outcome of Tuberculosis Case Surveillance at Kano Central Correctional Center, North-west Nigeria: A Need for Routine Active Case Findings for TB in Nigerian Correctional Centers

Tukur¹,

Odume²,

Bajehson³

et al. 2021

IJTDH

View full text Add to dashboard Cite

show abstract

Section: Introductionmentioning

confidence: 99%

“…Sputum smear microscopy as one of the phenotypic methods remains the most commonly used test for diagnosis and monitoring of treatment, despite being less sensitive and non-specific for Mycobacterium tuberculosis (M. tb), while mycobacterial culture, being identified and applied as the gold standard for TB diagnosis, has the disadvantage of providing results after a substantial period (3-4 weeks). [14][15][16][17] The tuberculosis molecular bacterial load assay (TB-MBLA) is a reverse transcriptase quantitative real-time polymerase chain reaction (RT-qPCR) of 16S rRNA detection test that quantifies TB bacillary load and is used as a marker of treatment response for patients on anti-TB therapy. 18 The assay is rapid, free of contamination, and can inform the elimination rate of M. tb during treatment.…”

Section: Introductionmentioning

confidence: 99%

Molecular bacterial load assay versus culture for monitoring treatment response in adults with tuberculosis

et al. 2021

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The lack of rapid, sensitive, and deployable tuberculosis diagnostic tools is hampering the early diagnosis of tuberculosis and early detection of treatment failures. The conventional sputum smear microscopy or Xpert MTB/RIF assay cannot distinguish between alive and dead bacilli and the culture method delays providing results. Tuberculosis molecular bacterial load assay is a reverse transcriptase real-time quantitative polymerase chain reaction that quantifies viable tuberculosis bacillary load as a marker of treatment response for patients on anti-tuberculosis therapy. However, results are not synthesized enough to inform its comparative advantage to tuberculosis culture technique which is yet the gold standard of care. With this review, we searched electronic databases, including PubMed, Embase, and Web of Science, from March 2011 up to February 2021 for clinical trials or prospective cohort studies that compared tuberculosis molecular bacterial load assay with tuberculosis culture in adults. We included eight studies that meet the inclusion criteria. Tuberculosis molecular bacterial load assay surpasses culture in monitoring patients with tuberculosis during the first few weeks of anti-tuberculosis treatment. It is more desirable over culture for its shorter time to results, almost zero rates of contamination, need for less expertise on the method, early rate of decline, lower running cost, and reproducibility. Its rapid and specific tuberculosis treatment monitoring competency benefits patients and healthcare providers to monitor changes of bacillary load among isolates with drug-susceptible or resistance to anti-tuberculosis regimens. Despite of the high installing cost of the tuberculosis molecular bacterial load assay method, molecular expertise, and a well-equipped laboratory, tuberculosis molecular bacterial load assay is a cost-effective method with comparison to culture in operational running. To achieve maximum utility in high tuberculosis burden settings, an intensive initial investment in nucleic acid extraction and polymerase chain reaction equipment, training in procedures, and streamlining laboratory supply procurement systems are crucial. More evidence is needed to demonstrate the potential large-scale and sustainable use of tuberculosis molecular bacterial load assay over culture in resource-constrained settings.

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“…The geneXpert examination is a rapid test using the automatic polymerase chain reaction (PCR) molecular test. This test can detect the presence of M. tuberculosis and resistance to rifampicin for less than 2 h. New generation technology of automated platforms for molecular diagnosis [ 13 , 14 ]. The standard TB mastoiditis treatment is in accordance with extrapulmonary TB treatment, namely with anti-tuberculosis drugs for at least 6 months.…”

Section: Discussionmentioning

confidence: 99%

Canal wall down in tuberculosis matoiditis: 4 case series

Mahdiani

Lasminingrum

Purwanto

et al. 2021

International Journal of Surgery Case Reports

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Background Tuberculosis of the ear and temporal bone is an extremely rare case. Methods This case series was reported using the 2020 PROCESS Guideline. The design of this study used a retrospective study during the 2017–2019 period . Results Four cases of tuberculosis mastoiditis with age range between 16 and 66 years from 2016 to 2019. All patients presented with chronic ear discharge from chronic ear with signs of mastoiditis with intra- and extra-temporal complications. All patients underwent radical mastoidectomy, and histopathologic examination showed tuberculosis. All patients received anti-tuberculosis drug first and second category. Conclusion Clinical features of tuberculosis mastoiditis may vary. The diagnosis of tuberculosis mastoiditis can be examined through histopathologic examination and geneXpert tuberculosis. Surgical treatment and anti-tuberculosis administration are the primary choices in the management of tuberculosis mastoiditis.

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Early chest X-ray in persons with presumptive tuberculosis increases Xpert® MTB/RIF diagnostic yield and efficiency

Cited by 5 publications

References 5 publications

Outcome of Tuberculosis Case Surveillance at Kano Central Correctional Center, North-west Nigeria: A Need for Routine Active Case Findings for TB in Nigerian Correctional Centers

Outcome of Tuberculosis Case Surveillance at Kano Central Correctional Center, North-west Nigeria: A Need for Routine Active Case Findings for TB in Nigerian Correctional Centers

Molecular bacterial load assay versus culture for monitoring treatment response in adults with tuberculosis

Canal wall down in tuberculosis matoiditis: 4 case series

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