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https://www.readbyqxmd.com/read/28529202/an-evaluation-of-automated-chest-radiography-reading-software-for-tuberculosis-screening-among-public-and-private-sector-patients
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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...
April 19, 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
#7
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
#8
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
https://www.readbyqxmd.com/read/28464797/modeling-the-patient-and-health-system-impacts-of-alternative-xpert%C3%A2-mtb-rif-algorithms-for-the-diagnosis-of-pulmonary-tuberculosis-in-addis-ababa-ethiopia
#9
Abraham Tesfaye, Daniel Fiseha, Dawit Assefa, Eveline Klinkenberg, Silvia Balanco, Ivor Langley
BACKGROUND: To reduce global tuberculosis (TB) burden, the active disease must be diagnosed quickly and accurately and patients should be treated and cured. In Ethiopia, TB diagnosis mainly relies on spot-morning-spot (SMS) sputum sample smear analysis using Ziehl-Neelsen staining techniques (ZN). Since 2014 targeted use of xpert has been implemented. New diagnostic techniques have higher sensitivity and are likely to detect more cases if routinely implemented. The objective of our study was to project the effects of alternative diagnostic algorithms on the patient, health system, and costs, and identify cost-effective algorithms that increase TB case detection in Addis Ababa, Ethiopia...
May 2, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28447869/mitigation-of-discordant-rifampicin-susceptibility-results-obtained-by-xpert-mycobacterium-tuberculosis-rifampicin-and-mycobacterium-growth-indicator-tube
#10
Elmira Gurbanova, Rafail Mehdiyev, Kai Blondal, Rasim Tahirli, Fuad Mirzayev, Doris Hillemann, Asker Ismayilov, Alan Altraja
BACKGROUND: Simultaneous use of genotypic and phenotypic diagnostic tools for detection of rifampicin (RIF) susceptibility may yield discrepant results. OBJECTIVE: To measure the discordance between the RIF-susceptibility results by Xpert MTB/RIF and Mycobacterium Growth Indicator Tube (MGIT), to evaluate if application of both tests to the same sample affects the discrepancy, and to evaluate treatment outcome in patients with the discordant strains. DESIGN: Sputa from patients with tuberculosis managed in the penitentiary system of Azerbaijan during 2011-2015 were examined for RIF susceptibility using Xpert MTB/RIF and MGIT...
April 27, 2017: Microbial Drug Resistance: MDR: Mechanisms, Epidemiology, and Disease
https://www.readbyqxmd.com/read/28442117/tuberculosis-toxoplasmosis-co-infection-in-egyptian-patients-a-reciprocal-impact
#11
Mervat Mashaly, Nairmen Nabih, Iman M Fawzy, Abeer A El Henawy
OBJECTIVE: To assess the concurrent toxoplasmosis infection in Egyptian TB patients and the impact of each infection on the other in terms of increased severity of TB or reactivation of latent Toxoplasma infection. METHODS: Three hundred suspected pulmonary TB cases were initially screened for TB using direct Ziehl Neelsen staining and Lowenstein Jensen culture of their sputa. Rifampicin resistance was detected by Xpert MTB/RIF assay. Control group of 30 age and sex-matched healthy individuals negative for TB was included for comparison...
March 2017: Asian Pacific Journal of Tropical Medicine
https://www.readbyqxmd.com/read/28438139/digital-cxr-with-computer-aided-diagnosis-versus-symptom-screen-to-define-presumptive-tuberculosis-among-household-contacts-and-impact-on-tuberculosis-diagnosis
#12
Monde Muyoyeta, Nkatya Chanda Kasese, Deborah Milimo, Isaac Mushanga, Mapopa Ndhlovu, Nathan Kapata, Maureen Moyo-Chilufya, Helen Ayles
BACKGROUND: Household (HH) contact tracing is a strategy that targets high risk groups for TB. Symptom based screening is the standard used to identify HH contacts at risk for TB during HH contact tracing for TB. However, this strategy may be limited due to poor performance in predicting TB. The objective of this study was to compare CXR with Computer Aided Diagnosis (CAD) against symptom screen for defining presumptive TB and how TB detection changes with each method. METHODS: Household contacts of consecutive index bacteriologically confirmed TB cases were visited by study teams and given TB/HIV education to raise awareness of the risk of TB following close contact with a TB patient...
April 24, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28430807/diagnosis-of-smear-negative-tuberculosis-is-greatly-improved-by-xpert-mtb-rif
#13
Giulia Lombardi, Valentina Di Gregori, Nicolò Girometti, Marina Tadolini, Francesco Bisognin, Paola Dal Monte
BACKGROUND: Diagnosis of pulmonary (PTB) and extra-pulmonary tuberculosis (EPTB) in smear-negative patients can be difficult. We assessed retrospectively the performance of Xpert MTB/RIF system (Xpert, Cepheid) in diagnosing smear-negative tuberculosis (TB), which represents the most common form of TB in a low incidence setting. METHODS: Performance of Xpert was compared to acid-fast microscopic examination using Ziehl-Neelsen (ZN) stain in patients with culture-confirmed TB...
2017: PloS One
https://www.readbyqxmd.com/read/28425873/rapid-detection-of-mycobacterium-tuberculosis-and-rifampicin-resistance-in-extrapulmonary-tuberculosis-and-sputum-smear-negative-pulmonary-suspects-using-xpert-mtb-rif
#14
Irfan Ullah, Arshad Javaid, Haleema Masud, Mazhar Ali, Anila Basit, Waqas Ahmad, Faisal Younis, Rehana Yasmin, Afsar Khan, Abdul Jabbar, Masroor Husain, Zahid Ahmad Butt
BACKGROUND: Tuberculosis (TB) is a serious public health problem in developing countries such as Pakistan. Rapid diagnosis of TB and detection of drug resistance are very important for timely and appropriate management of multidrug-resistant TB (MDR-TB). OBJECTIVE: The purpose of this study was to determine the diagnostic efficacy of the Xpert MTB/RIF assay for rapid diagnosis of TB and detection of rifampicin (RIF) resistance in extrapulmonary and smear-negative pulmonary TB suspects...
April 2017: Journal of Medical Microbiology
https://www.readbyqxmd.com/read/28399964/pooling-sputum-samples-to-improve-the-feasibility-of-xpert-%C3%A2-mtb-rif-in-systematic-screening-for-tuberculosis
#15
J Ho, P Jelfs, P T B Nguyen, V Sintchenko, G J Fox, G B Marks
SETTING: Systematic screening for tuberculosis (TB) using Xpert® MTB/RIF. OBJECTIVE: To determine whether pooling sputum samples for Xpert testing may improve the feasibility and cost-effectiveness of Xpert by reducing the number of Xpert tests required. DESIGN: Mycobacterium tuberculosis-spiked sputum samples at low organism concentrations were used to mimic samples that are more likely to be found in the screening, compared to the diagnostic, setting...
May 1, 2017: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/28399963/diagnostic-accuracy-of-the-xpert-%C3%A2-mtb-rif-cycle-threshold-level-to-predict-smear-positivity-a-meta-analysis
#16
B Lange, P Khan, G Kalmambetova, H A Al-Darraji, D Alland, U Antonenka, T Brown, M E Balcells, R Blakemore, C M Denkinger, K Dheda, H Hoffmann, A Kadyrov, N Lemaitre, M B Miller, V Nikolayevskyy, E N Ntinginya, N Ozkutuk, J J Palacios, E B Popowitch, J M Porcel, J Teo, G Theron, K Kranzer
SETTING: Xpert® MTB/RIF is the most widely used molecular assay for rapid diagnosis of tuberculosis (TB). The number of polymerase chain reaction cycles after which detectable product is generated (cycle threshold value, CT) correlates with the bacillary burden.OBJECTIVE To investigate the association between Xpert CT values and smear status through a systematic review and individual-level data meta-analysis. DESIGN: Studies on the association between CT values and smear status were included in a descriptive systematic review...
May 1, 2017: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/28391384/the-role-of-xpert-mtb-rif-assay-in-the-diagnosis-of-tubercular-spondylodiscitis
#17
Justin Arockiaraj, Joy S Michael, Rohit Amritanand, Kenny Samuel David, Venkatesh Krishnan
PURPOSE: This study aims to assess the accuracy of the Xpert MTB/RIF assay in the diagnosis of tubercular spondylodiscitis and to identify its role in detecting Rifampicin resistance in patients with infective spondylodiscitis. METHODS: A retrospective study including 348 patients suspected to have infective spondylodiscitis was done. Tissue/pus samples obtained were sent for culture, histopathology and Xpert MTB/RIF assay. All patients who were confirmed to have tubercular spondylodiscitis and those patients who were suspected on clinico-radiological basis were also treated with anti-tuberculous chemotherapy for a period of 9 months...
April 8, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28380276/microscopic-observation-drug-susceptibility-assay-vs-xpert-%C3%A2-mtb-rif-for-the-diagnosis-of-tuberculosis-in-a-rural-african-setting-a-cost-utility-analysis
#18
Philip E Wikman-Jorgensen, Jara Llenas-García, Tomàs M Pérez-Porcuna, Michael Hobbins, Jochen Ehmer, Manuel A Mussa, Carlos Ascaso
OBJECTIVE: To compare the cost-utility of microscopic observation drug-susceptibility assay (MODS) and Xpert(®) MTB/RIF implementation for tuberculosis (TB) diagnosis in rural northern Mozambique. METHODS: Stochastic transmission compartmental TB model from the healthcare provider perspective with parameter input from direct measurements, systematic literature reviews and expert opinion. MODS and Xpert(®) MTB/RIF were evaluated as replacement test of smear microscopy (SM) or as an add-on test after a negative SM...
April 5, 2017: Tropical Medicine & International Health: TM & IH
https://www.readbyqxmd.com/read/28372894/the-additional-role-of-xpert-mtb-rif-in-the-diagnosis-of-intrathoracic-tuberculous-lymphadenitis
#19
Jinwoo Lee, Sun Mi Choi, Chang-Hoon Lee, Sang-Min Lee, Jae-Joon Yim, Chul-Gyu Yoo, Young Whan Kim, Sung Koo Han, Young Sik Park
BACKGROUND: Diagnosis of intrathoracic tuberculosis (TB) lymphadenitis remains a challenge because of difficulties in obtaining adequate tissue and the lack of a sensitive test. Recently, Xpert MTB/RIF assay is being used for rapid diagnosis of pulmonary TB, but it has not yet been widely validated in intrathoracic TB lymphadenitis. The aim of this study was to assess the additional role of Xpert MTB/RIF in diagnosing intrathoracic TB lymphadenitis using endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) specimen...
March 31, 2017: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/28358797/evaluation-of-automated-molecular-testing-rollout-for-tuberculosis-diagnosis-using-routinely-collected-surveillance-data-uganda-2012-2015
#20
Colleen Scott, Simon Walusimbi, Bruce Kirenga, Moses Joloba, Muttamba Winters, Nyombi Abdunoor, Rommel Bain, Heather Alexander, Tom Shinnick, Sean Toney, Rosemary Odeke, Christine Mwangi, Estella Birabwa, Seyoum Dejene, Frank Mugabe, Mukadi YaDiul, J Sean Cavanaugh
In 2012, Uganda introduced the use of GeneXpert MTB/RIF (Cepheid, Sunnyvale CA), a sensitive, automated, real-time polymerase chain reaction-based platform for tuberculosis (TB) diagnosis, for programmatic use among children, adults with presumptive human immunodeficiency virus (HIV)-associated TB, and symptomatic persons at risk for rifampicin (RIF)-resistant TB. The effect of using the platform's Xpert MTB/RIF assay on TB care and control was assessed using routinely collected programmatic data; in addition, a retrospective review of district quarterly summaries using abstracted TB register data from purposively selected facilities in the capital city of Kampala was conducted...
March 31, 2017: MMWR. Morbidity and Mortality Weekly Report
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