2012
DOI: 10.1093/cid/cis631
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Evaluation of the Xpert MTB/RIF Assay at a Tertiary Care Referral Hospital in a Setting Where Tuberculosis and HIV Infection Are Highly Endemic

Abstract: BACKGROUND. There were 1.45 million deaths from tuberculosis in 2011. A substantial proportion of active pulmonary tuberculosis cases in countries where tuberculosis, human immunodeficiency virus (HIV) infection, and AIDS are highly endemic remain undiagnosed because of the reliance on sputum-smear microscopy. This study evaluated the performance of the Xpert MTB/RIF assay at a tertiary care referral center in Zambia, a country where the burden of tuberculosis and HIV infection is high. METHODS. A total of 881… Show more

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Cited by 64 publications
(54 citation statements)
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“…Key potential entry points for TB screening are illustrated in Figure 1. TB screening can be conducted at the clinic, facility or community level (Table 1), [6][7][8][9][10][11][12] and can be initiated by TB programmes, infection control services in general facilities or HIV testing and care services. Developing and scaling up effective TB screening strategies will ideally follow the same kind of combined approach that has proved effective for HIV testing and counselling (HTC).…”
Section: Discussionmentioning
confidence: 99%
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“…Key potential entry points for TB screening are illustrated in Figure 1. TB screening can be conducted at the clinic, facility or community level (Table 1), [6][7][8][9][10][11][12] and can be initiated by TB programmes, infection control services in general facilities or HIV testing and care services. Developing and scaling up effective TB screening strategies will ideally follow the same kind of combined approach that has proved effective for HIV testing and counselling (HTC).…”
Section: Discussionmentioning
confidence: 99%
“…46,47 In practice, TB screening usually starts with either symptoms or X-ray, 48 although there is increasing use of Xpert® MTB/RIF (Cepheid, Sunnyvale, CA, USA) as both initial and confirmatory test. 9,[49][50][51] The performance of all tests tends to be less good due to lower sensitivity when used for screening than for patient-initiated diagnostic testing, as the spectrum of undiagnosed disease detected is shifted towards earlier, paucibacillary cases (Figures 2 and 3): this includes culture, smear microscopy and Xpert. 30,41,49,50,[52][53][54] There is considerable incremental yield from combining different tests, or repeating the same test on different specimens.…”
Section: Optimal Screening Strategies For Different Priority Groupsmentioning
confidence: 99%
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