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https://www.readbyqxmd.com/read/28633698/feasibility-of-a-streamlined-tuberculosis-diagnosis-and-treatment-initiation-strategy
#1
P B Shete, T Nalugwa, K Farr, C Ojok, M Nantale, P Howlett, P Haguma, E Ochom, F Mugabe, M Joloba, L H Chaisson, D W Dowdy, D Moore, J L Davis, A Katamba, A Cattamanchi
OBJECTIVE: To assess the feasibility of a streamlined strategy for improving tuberculosis (TB) diagnostic evaluation and treatment initiation among patients with presumed TB. DESIGN: Single-arm interventional pilot study at five primary care health centers of a streamlined, SIngle-saMPLE (SIMPLE) TB diagnostic evaluation strategy: 1) examination of two smear results from a single spot sputum specimen using light-emitting diode fluorescence microscopy, and 2) daily transportation of smear-negative sputum samples to Xpert® MTB/RIF testing sites...
July 1, 2017: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/28628437/nontuberculous-mycobacteria-infections-at-a-provincial-reference-hospital-cambodia
#2
Maryline Bonnet, Kim Chamroeun San, Yati Pho, Chandara Sok, Jean-Philippe Dousset, William Brant, Northan Hurtado, Khun Kim Eam, Elisa Ardizzoni, Seiha Heng, Sylvain Godreuil, Wing-Wai Yew, Cathy Hewison
Prevalence of nontuberculous mycobacteria (NTM) disease is poorly documented in countries with high prevalence of tuberculosis (TB). We describe prevalence, risk factors, and TB program implications for NTM isolates and disease in Cambodia. A prospective cohort of 1,183 patients with presumptive TB underwent epidemiologic, clinical, radiologic, and microbiologic evaluation, including >12-months of follow-up for patients with NTM isolates. Prevalence of NTM isolates was 10.8% and of disease was 0.9%; 217 (18...
July 2017: Emerging Infectious Diseases
https://www.readbyqxmd.com/read/28622763/treatment-decisions-and-mortality-in-hiv-positive-presumptive-smear-negative-tb-in-the-xpert%C3%A2-mtb-rif-era-a-cohort-study
#3
Sabine M Hermans, Juliet A Babirye, Olive Mbabazi, Francis Kakooza, Robert Colebunders, Barbara Castelnuovo, Christine Sekaggya-Wiltshire, Rosalind Parkes-Ratanshi, Yukari C Manabe
BACKGROUND: The Xpert™ MTB/RIF (XP) has a higher sensitivity than sputum smear microscopy (70% versus 35%) for TB diagnosis and has been endorsed by the WHO for TB high burden countries to increase case finding among HIV co-infected presumptive TB patients. Its impact on the diagnosis of smear-negative TB in a routine care setting is unclear. We determined the change in diagnosis, treatment and mortality of smear-negative presumptive TB with routine use of Xpert MTB/RIF (XP). METHODS: Prospective cohort study of HIV-positive smear-negative presumptive TB patients during a 12-month period after XP implementation in a well-staffed and trained integrated TB/HIV clinic in Kampala, Uganda...
June 16, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28619229/cost-effectiveness-of-xpert-mtb-rif-for-tuberculosis-diagnosis-in-south-africa-a-real-world-cost-analysis-and-economic-evaluation
#4
Anna Vassall, Mariana Siapka, Nicola Foster, Lucy Cunnama, Lebogang Ramma, Katherine Fielding, Kerrigan McCarthy, Gavin Churchyard, Alison Grant, Edina Sinanovic
BACKGROUND: In 2010 a new diagnostic test for tuberculosis, Xpert MTB/RIF, received a conditional programmatic recommendation from WHO. Several model-based economic evaluations predicted that Xpert would be cost-effective across sub-Saharan Africa. We investigated the cost-effectiveness of Xpert in the real world during national roll-out in South Africa. METHODS: For this real-world cost analysis and economic evaluation, we applied extensive primary cost and patient event data from the XTEND study, a pragmatic trial examining Xpert introduction for people investigated for tuberculosis in 40 primary health facilities (20 clusters) in South Africa enrolled between June 8, and Nov 16, 2012, to estimate the costs and cost per disability-adjusted life-year averted of introducing Xpert as the initial diagnostic test for tuberculosis, compared with sputum smear microscopy (the standard of care)...
July 2017: Lancet Global Health
https://www.readbyqxmd.com/read/28611407/evaluation-of-the-mtbdrplus-2-0-assay-for-the-detection-of-multidrug-resistance-among-persons-with-presumptive-pulmonary-tb-in-china
#5
Yaoju Tan, Qiang Li, Qing Wang, Huiping Sun, Jin Chen, Xingshan Cai, Yinchai Yao, Xundi Bao, Chao Wang, Yuan Liu, Xia Wu, Yu Pang, Yanlin Zhao
We have conducted a multicenter study of the diagnostic accuracy of the MTBDRplus 2.0 assay in compared with conventional and molecular reference standard in four tuberculosis (TB)-specialized hospitals of China. A total of 5038 patients were enrolled in this study. The overall sensitivity of the assay for the diagnosis of TB was 92.7% [1723/1858, 95% confidence interval (95% CI): 91.5-93.9]. In smear-positive/culture-positive cases the sensitivity was 97.7% (995/1018, 95% CI: 96.6-98.6), whereas in smear-negative/culture-positive cases it was 86...
June 13, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28610793/a-novel-automatic-molecular-test-for-detection-of-multidrug-resistance-tuberculosis-in-sputum-specimen-a-case-control-study
#6
Qiang Li, Xi C Ou, Yu Pang, Hui Xia, Hai R Huang, Bing Zhao, Sheng F Wang, Yan L Zhao
MiniLab tuberculosis (ML TB) assay is a new automatic diagnostic tool for diagnosis of multidrug resistance tuberculosis (MDR-TB). This study was conducted with aims to know the performance of this assay. Sputum sample from 224 TB suspects was collected from tuberculosis suspects seeking medical care at Beijing Chest hospital. The sputum samples were directly used for smear and ML TB test. The left sputum sample was used to conduct Xpert MTB/RIF, Bactec MGIT culture and drug susceptibility test (DST). All discrepancies between the results from DST, molecular and phenotypic methods were confirmed by DNA Sequencing...
July 2017: Tuberculosis
https://www.readbyqxmd.com/read/28592547/performance-of-the-abbott-realtime-mtb-and-mtb-rif-inh-assays-in-a-high-tb-and-hiv-coinfection-setting-in-south-africa
#7
Lesley Scott, Anura David, Lara Noble, Matilda Nduna, Pedro Da Silva, Andrew Black, Francois Venter, Wendy Stevens
Background: South Africa is a country with a high incidence of tuberculosis (TB), complicated by coinfection with HIV. The Xpert MTB/RIF (Cepheid, Sunnyvale, CA, USA) is used in South Africa as the test for initial diagnosis of TB, and other molecular platforms such as the m2000 (Abbott Molecular, Des Plaines, IL, USA) are widely used for molecular monitoring of HIV viral load. This latter platform is now also equipped with the RealTime MTB and RealTime MTB RIF/INH assays for TB and first line drug resistance screening, but has not been evaluated in settings of HIV and TB coinfection...
June 7, 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/28588939/cost-effectiveness-of-triage-testing-for-facility-based-systematic-screening-of-tuberculosis-among-ugandan-adults
#8
Matthew Murray, Adithya Cattamanchi, Claudia Denkinger, Anja Van't Hoog, Madhukar Pai, David Dowdy
BACKGROUND: Systematic screening is often proposed as a way to improve case finding for tuberculosis (TB), but the cost-effectiveness of specific strategies for systematic screening remains poorly studied. METHODS: We constructed a Markov-based decision analytic model to analyse the cost-effectiveness of triage testing for TB in Uganda, compared against passive case detection with Xpert MTB/RIF. We assumed a triage algorithm whereby all adults presenting to healthcare centres would be screened for cough, and those with cough of at least 2 weeks would receive the triage test, with positive triage results confirmed by Xpert MTB/RIF...
August 2016: BMJ Global Health
https://www.readbyqxmd.com/read/28583076/diagnostic-accuracy-of-nucleic-acid-amplification-tests-naats-in-urine-for-genitourinary-tuberculosis-a-systematic-review-and-meta-analysis
#9
Carlos Altez-Fernandez, Victor Ortiz, Majid Mirzazadeh, Luis Zegarra, Carlos Seas, Cesar Ugarte-Gil
BACKGROUND: Genitourinary tuberculosis is the third most common form of extrapulmonary tuberculosis. Diagnosis is difficult because of unspecific clinical manifestations and low accuracy of conventional tests. Unfortunately, the delayed diagnosis impacts the urinary tract severely. Nucleic acid amplification tests yield fast results, and among these, new technologies can also detect drug resistance. There is lack of consensus regarding the use of these tests in genitourinary tuberculosis; we therefore aimed to assess the accuracy of nucleic acid amplification tests in the diagnosis of genitourinary tuberculosis and to evaluate the heterogeneity between studies...
June 5, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28577535/tuberculosis-screening-among-persons-with-diabetes-mellitus-in-pune-india
#10
Vidya Mave, Smita Nimkar, Haridas Prasad, Dileep Kadam, Sushant Meshram, Rahul Lokhande, Nikhil Gupte, Divyashri Jain, Amita Gupta, Jonathan E Golub
BACKGROUND: Diabetes mellitus (DM) increases tuberculosis (TB) risk, and there is increasing concern over the public health implications of the convergence of these two epidemics. Screening for TB among people with DM is now recommended in India. METHODS: People with DM seeking care at a large public sector tertiary care hospital clinic in Pune, India, were screened for TB from June 2015 to May 2016. All consenting people with DM were screened for TB at each clinic visit using a five-item, WHO-recommended questionnaire and those with TB symptoms and/or risk factors were tested for active TB using sputum smear microscopty, Xpert® MTB/RIF and TB culture...
June 2, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28558662/evaluation-of-gene-xpert-for-routine-diagnosis-of-hiv-associated-tuberculosis-in-nigeria-a-prospective-cohort-study
#11
Maxwell Oluwole Akanbi, Chad Achenbach, Babafemi Taiwo, John Idoko, Agatha Ani, Yetunde Isa, Oche Agbaji, Christiana Ukoli, Patrick Akande, Mamoudou Maiga, Robert Leo Murphy
BACKGROUND: Xpert MTB/Rif (Xpert) is described as a game changer in tuberculosis (TB) control. We evaluated the impact of Xpert on diagnosis, time to treatment, and treatment outcome among patients with HIV associated TB in Nigeria. METHODS: Adults with HIV being evaluated for pulmonary TB (PTB) were consecutively enrolled into the study cohort. At baseline, expectorated sputa were examined using Xpert and smear microscopy for Mycobacterium tuberculosis (MTB) and acid fast bacilli, respectively...
May 30, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28543876/application-of-molecular-microbiological-and-immunological-tests-for-the-diagnosis-of-bone-and-joint-tuberculosis
#12
Yinghua Tang, Lianli Yin, Shifu Tang, Hongyu Zhang, Jihui Lan
BACKGROUND: To evaluate the application of interferon gamma release assay (IGRA), rifampicin resistant real-time fluorescence quantitative PCR technique Xpert Mycobacterium tuberculosis/rifampicin (Xpert MTB/RIF), and the levels of TNF-α and TGF-β in the diagnosis of bone and joint tuberculosis. METHODS: Eighty-six patients with bone and joint tuberculosis, diagnosed by pathology or microbiology, were examined by Xpert MTB/RIF and IGRA (T-SPOT. TB) for Mycobacterium tuberculosis infection, and the TNF-α and TGF-β levels of the patients were measured...
May 22, 2017: Journal of Clinical Laboratory Analysis
https://www.readbyqxmd.com/read/28529202/an-evaluation-of-automated-chest-radiography-reading-software-for-tuberculosis-screening-among-public-and-private-sector-patients
#13
Md Toufiq Rahman, Andrew J Codlin, Md Mahfuzur Rahman, Ayenun Nahar, Mehdi Reja, Tariqul Islam, Zhi Zhen Qin, Md Abdus Shakur Khan, Sayera Banu, Jacob Creswell
Computer-aided reading (CAR) of medical images is becoming increasingly common, but few studies exist for CAR in tuberculosis (TB). We designed a prospective study evaluating CAR for chest radiography (CXR) as a triage tool before Xpert MTB/RIF (Xpert).Consecutively enrolled adults in Dhaka, Bangladesh, with TB symptoms received CXR and Xpert. Each image was scored by CAR and graded by a radiologist. We compared CAR with the radiologist for sensitivity and specificity, area under the receiver operating characteristic curve (AUC), and calculated the potential Xpert tests saved...
May 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28522948/evaluation-of-xpert-mtb-rif-assay-performance-in-the-diagnosis-of-abdominal-tuberculosis
#14
Suraj Kumar, Sawan Bopanna, Saurabh Kedia, Pratap Mouli, Rajan Dhingra, Rajesh Padhan, Mikashmi Kohli, Jigyasa Chaubey, Rohini Sharma, Prasenjit Das, S Dattagupta, Govind Makharia, S K Sharma, Vineet Ahuja
BACKGROUND/AIMS: The use of genetic probes for the diagnosis of pulmonary tuberculosis (TB) has been well described. However, the role of these assays in the diagnosis of intestinal tuberculosis is unclear. We therefore assessed the diagnostic utility of the Xpert Mycobacterium tuberculosis/rifampicin (MTB/RIF) assay, and estimated the prevalence of multidrug-resistant (MDR) TB in the Indian population. METHODS: Of 99 patients recruited, 37 had intestinal TB; two control groups comprised 43 with Crohn's disease (CD) and 19 with irritable bowel syndrome...
April 2017: Intestinal Research
https://www.readbyqxmd.com/read/28501491/diagnostic-usefulness-of-xpert-mtb-rif-assay-for-detection-of-tuberculous-meningitis-using-cerebrospinal-fluid
#15
Syed Beenish Rufai, Amit Singh, Jitendra Singh, Parveen Kumar, Manimuthu Mani Sankar, Sarman Singh
OBJECTIVE: Tuberculous meningitis (TBM) is the most severe form of extra-pulmonary tuberculosis (TB) due to association of diseases with high rates of mortality and morbidity. Diagnosis continues to be a clinical challenge as microbiological confirmation is rare and time consuming resulting in delayed treatment. Xpert MTB/RIF assay is a rapid and simple test, which has been endorsed by World Health Organization as an initial diagnostic test for the diagnosis of TBM. However, evidence still lacks for its performance on cerebrospinal fluid (CSF) for the diagnosis of TBM especially from India...
May 10, 2017: Journal of Infection
https://www.readbyqxmd.com/read/28499418/early-morning-urine-collection-to-improve-urinary-lateral-flow-lam-assay-sensitivity-in-hospitalised-patients-with-hiv-tb-co-infection
#16
Phindile Gina, Philippa J Randall, Tapuwa E Muchinga, Anil Pooran, Richard Meldau, Jonny G Peter, Keertan Dheda
BACKGROUND: Urine LAM testing has been approved by the WHO for use in hospitalised patients with advanced immunosuppression. However, sensitivity remains suboptimal. We therefore examined the incremental diagnostic sensitivity of early morning urine (EMU) versus random urine sampling using the Determine® lateral flow lipoarabinomannan assay (LF-LAM) in HIV-TB co-infected patients. METHODS: Consenting HIV-infected inpatients, screened as part of a larger prospective randomized controlled trial, that were treated for TB, and could donate matched random and EMU samples were included...
May 12, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28490246/evaluation-of-xpert-mtb-rif-assay-in-children-with-presumed-pulmonary-tuberculosis-in-papua-new-guinea
#17
Sharon Kasa Tom, Henry Welch, Cornelia Kilalang, Nakapi Tefuarani, John Vince, Evelyn Lavu, Karen Johnson, Ruth Magaye, Trevor Duke
BACKGROUND: The Gene Xpert MTB/ RIF assay (Xpert) is used for rapid, simultaneous detection of Mycobacterium tuberculosis (MTB) and rifampicin resistance. This study examined the accuracy of Xpert in children with suspected pulmonary tuberculosis (PTB). METHODS: Children admitted to Port Moresby General Hospital with suspected PTB were prospectively enrolled between September 2014 and March 2015. They were classified into probable, possible and TB-unlikely groups...
May 11, 2017: Paediatrics and International Child Health
https://www.readbyqxmd.com/read/28486175/ileocaecal-and-transverse-colonic-tuberculosis-mimicking-colonic-malignancy-a-case-report
#18
Prashant Lakhe, Asma Khalife, Jayashri Pandya
INTRODUCTION: Gastrointestinal tuberculosis is common in the developing world especially in the lower socioeconomic groups. In elderly, it may mimic malignancy. CASE PRESENTATION: A 46-year-old female presented with a 6 month history of diffuse pain in abdomen with low grade fever and loss of weight and appetite. Clinically, differential of malignancy of the large bowel was considered. The computerized tomography(CT) scan of the abdomen revealed a diffuse concentric long segmental thickening of terminal ileum, ileo ceacal junction, ascending colon and narrowing of the transverse colonic end of the splenic flexure suggesting an infective etiology...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28482964/the-sensitivity-of-the-quantiferon-%C3%A2-tb-gold-plus-assay-in-zambian-adults-with-active-tuberculosis
#19
L Telisinghe, M Amofa-Sekyi, K Maluzi, D Kaluba-Milimo, M Cheeba-Lengwe, K Chiwele, B Kosloff, S Floyd, S-L Bailey, H Ayles
SETTING AND OBJECTIVE: To investigate the sensitivity of the new interferon-gamma release assay (IGRA), QuantiFERON®-TB Gold Plus (QFT-Plus), for active TB (used as a surrogate for latent tuberculous infection) in a Zambian TB clinic. DESIGN: Consecutive smear or Xpert® MTB/RIF-positive adult (age 18 years) pulmonary TB patients were recruited between June 2015 and March 2016. Venous blood was tested using QFT-Plus. The sensitivity was defined as the number positive divided by the total number tested...
June 1, 2017: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/28475796/real-life-clinical-practice-of-using-the-xpert-mtb-rif-assay-in-thailand
#20
Kamon Kawkitinarong, Gompol Suwanpimolkul, Pairaj Kateruttanakul, Weerawat Manosuthi, Sasiwimol Ubolyam, Jiratchaya Sophonphan, Anchalee Avihingsanon, Kiat Ruxrungtham
Background: Delayed diagnosis of tuberculosis (TB) and drug-resistant TB are major challenges of TB control in Thailand. This study assessed the practicality of the Xpert MTB/RIF assay in a real-life setting with high prevalence of human immunodeficiency virus (HIV) infection and pulmonary tuberculosis (PTB). Methods: This prospective study was conducted at 3 large tertiary care hospitals. Patients who had suspected PTB were enrolled into the study. Expectorated sputum samples were sent for staining, mycobacterial culture, and Xpert MTB/RIF...
May 15, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
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