Epidemiological analyses of tuberculosis in Archangelsk, Russia and implementation of a rapid assay for detection of resistance in this high burden setting

Eliseev, P. I.; Марьяндышев, А О; Никишова, Е. И.; Тарасова, И. В.; Gorina, Galina P; Chryssanthou, Erja; Ridell, Malin; Larsson, Lars-Olof

doi:10.1016/j.ijmyco.2013.04.002

Cited by 8 publications

(9 citation statements)

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“…NIHR Journals Library www.journalslibrary.nihr.ac.uk studies (n = 18), 34,[62][63][64][65][66][67][68][69][70][71][72][73][74][75][98][99][100] MTBDRsl studies (n = 6) 37,76-80 and other rapid diagnostic studies (n = 17); [81][82][83][84][85][86][87][88][89][90][91][92][93][94][95][96][97] the last category comprised any report with insufficient information about the type and manufacture of the assay tested, or assays that had been designed in-house.…”

Section: Systematic Reviewmentioning

confidence: 99%

“…A total of 18 studies 34,[62][63][64][65][66][67][68][69][70][71][72][73][74][75][98][99][100] reporting the use of GenoType MTBDRplus ® (Hain Lifescience, Nehren, Germany) were eligible for inclusion into the meta-analysis ( Table 6). …”

Section: Findings Of the Reviewmentioning

confidence: 99%

“…Asencios (2012) 71 Barnard (2008) 70 Farooqi (2012) 65 Hillemann (2006) I -V overall Farooqi (2012) 65 Macedo (2009) 98 Asencios (2012) 71 Tukvadze (2012) 62 Hillemann (2006) 71 Lacoma (2008) 75 73 Hillemann (2006) 64 Crudu (2012) 69 Lyu (2013) 63 66 Nikolayevskyy (2009) 99 Maschmann (2013) 100 Barnard (2008) 70 68 Somoskovi (2006) 74 I -V overall Eliseev (2013) 66 Anek-Vorapong (2010) 72 Macedo (2009) 98 Farooqi (2012) 66 Asencios (2012) 71 Macedo (2009) 98 Farooqi (2012) 65 Hillemann (2006) 64 99 Cauwelaert (2011) 67 Anek-Vorapong (2010) 72 Somoskovi (2006) 74 Eliseev (2013) 66 Albert (2010) 73 Barnard (2008) 70 I -V overall Mironova (2012) 34 Lacoma (2008) 75 68 Maschmann (2013) …”

Section: Studymentioning

confidence: 99%

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Systematic review, meta-analysis and economic modelling of molecular diagnostic tests for antibiotic resistance in tuberculosis

Drobniewski

Cooke

Jordan

et al. 2015

Health Technology Assessment

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BackgroundDrug-resistant tuberculosis (TB), especially multidrug-resistant (MDR, resistance to rifampicin and isoniazid) disease, is associated with a worse patient outcome. Drug resistance diagnosed using microbiological culture takes days to weeks, as TB bacteria grow slowly. Rapid molecular tests for drug resistance detection (1 day) are commercially available and may promote faster initiation of appropriate treatment.ObjectivesTo (1) conduct a systematic review of evidence regarding diagnostic accuracy of molecular genetic tests for drug resistance, (2) conduct a health-economic evaluation of screening and diagnostic strategies, including comparison of alternative models of service provision and assessment of the value of targeting rapid testing at high-risk subgroups, and (3) construct a transmission-dynamic mathematical model that translates the estimates of diagnostic accuracy into estimates of clinical impact.Review methods and data sourcesA standardised search strategy identified relevant studies from EMBASE, PubMed, MEDLINE, Bioscience Information Service (BIOSIS), System for Information on Grey Literature in Europe Social Policy & Practice (SIGLE) and Web of Science, published between 1 January 2000 and 15 August 2013. Additional ‘grey’ sources were included. Quality was assessed using quality assessment of diagnostic accuracy studies version 2 (QUADAS-2). For each diagnostic strategy and population subgroup, a care pathway was constructed to specify which medical treatments and health services that individuals would receive from presentation to the point where they either did or did not complete TB treatment successfully. A total cost was estimated from a health service perspective for each care pathway, and the health impact was estimated in terms of the mean discounted quality-adjusted life-years (QALYs) lost as a result of disease and treatment. Costs and QALYs were both discounted at 3.5% per year. An integrated transmission-dynamic and economic model was used to evaluate the cost-effectiveness of introducing rapid molecular testing (in addition to culture and drug sensitivity testing). Probabilistic sensitivity analysis was performed to evaluate the impact on cost-effectiveness of diagnostic and treatment time delays, diagnosis and treatment costs, and associated QALYs.ResultsA total of 8922 titles and abstracts were identified, with 557 papers being potentially eligible. Of these, 56 studies contained sufficient test information for analysis. All three commercial tests performed well when detecting drug resistance in clinical samples, although with evidence of heterogeneity between studies. Pooled sensitivity for GenoType®MTBDRplus (Hain Lifescience, Nehren, Germany) (isoniazid and rifampicin resistance), INNO-LiPA Rif.TB®(Fujirebio Europe, Ghent, Belgium) (rifampicin resistance) and Xpert®MTB/RIF (Cepheid Inc., Sunnyvale, CA, USA) (rifampicin resistance) was 83.4%, 94.6%, 95.4% and 96.8%, respectively; equivalent pooled specificity was 99.6%, 98.2%, 99.7% and 98.4%, respectively. Results of the transmission model suggest that all of the rapid assays considered here, if added to the current diagnostic pathway, would be cost-saving and achieve a reduction in expected QALY loss compared with current practice. GenoType MTBDRplus appeared to be the most cost-effective of the rapid tests in the South Asian population, although results were similar for GeneXpert. In all other scenarios GeneXpert appeared to be the most cost-effective strategy.ConclusionsRapid molecular tests for rifampicin and isoniazid resistance were sensitive and specific. They may also be cost-effective when added to culture drug susceptibility testing in the UK. There is global interest in point-of-care testing and further work is needed to review the performance of emerging tests and the wider health-economic impact of decentralised testing in clinics and primary care, as well as non-health-care settings, such as shelters and prisons.Study registrationThis study is registered as PROSPERO CRD42011001537.FundingThe National Institute for Health Research Health Technology Assessment programme.

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Section: Systematic Reviewmentioning

confidence: 99%

Section: Findings Of the Reviewmentioning

confidence: 99%

Section: Studymentioning

confidence: 99%

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Systematic review, meta-analysis and economic modelling of molecular diagnostic tests for antibiotic resistance in tuberculosis

Drobniewski

Cooke

Jordan

et al. 2015

Health Technology Assessment

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“…Successful treatment outcomes for children with MDR-TB vary widely in other settings, ranging from 53% to 97% [4].The Arkhangelsk region has one of the highest rates of MDR-TB in Russia [5]. The first paediatric MDR-TB case was registered in 2001.…”

mentioning

confidence: 99%

“…The Arkhangelsk region has one of the highest rates of MDR-TB in Russia [5]. The first paediatric MDR-TB case was registered in 2001.…”

mentioning

confidence: 99%

Multidrug-resistant tuberculosis in children in northwest Russia: an observational cohort study

et al. 2016

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Outbreak of tuberculosis in a closed setting: views on transmission based on results from molecular and conventional methods

Антушева

Mironuk²,

Тарасова³

et al. 2016

Journal of Hospital Infection

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Epidemiological analyses of tuberculosis in Archangelsk, Russia and implementation of a rapid assay for detection of resistance in this high burden setting

Abstract: In Archangelsk many TB patients had contagious MDR-TB thus being hazardous in society and relapsing pulmonary TB was common. The TB situation in the prisons was particularly severe. The analyses showed furthermore that MTBDRplus is of major value in this setting.

Cited by 8 publications

References 24 publications

Systematic review, meta-analysis and economic modelling of molecular diagnostic tests for antibiotic resistance in tuberculosis

Systematic review, meta-analysis and economic modelling of molecular diagnostic tests for antibiotic resistance in tuberculosis

Multidrug-resistant tuberculosis in children in northwest Russia: an observational cohort study

Outbreak of tuberculosis in a closed setting: views on transmission based on results from molecular and conventional methods

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