Iem, Vibol, Chittamany, Phonenaly, Suthepmany, Sakhone, Siphanthong, Souvimone, Siphanthong, Phitsada, Somphavong, Silaphet, Kontogianni, Konstantina, Dodd, James, Khan, Jahangir Am, Dominguez, Jose et al (show 3 more authors)
(2022)
Pooled testing of sputum with Xpert MTB/RIF and Xpert Ultra during tuberculosis active case finding campaigns in Lao People's Democratic Republic.
BMJ GLOBAL HEALTH, 7 (2).
e007592-.
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Pooled testing of sputum with Xpert MTBRIF and Xpert Ultra during tuberculosis active case finding campaigns in Lao Peoples .pdf - Published version Download (1MB) | Preview |
Abstract
<h4>Introduction</h4>Active case finding (ACF) of individuals with tuberculosis (TB) is a key intervention to find the 30% of people missed every year. However, ACF requires screening large numbers of individuals who have a low probability of positive results, typically <5%, which makes using the recommended molecular tests expensive.<h4>Methods</h4>We conducted two ACF surveys (in 2020 and 2021) in high TB burden areas of Lao PDR. Participants were screened for TB symptoms and received a chest X-ray. Sputum samples of four consecutive individuals were pooled and tested with Xpert Mycobacterium tuberculosis (MTB)/rifampicin (RIF) (Xpert-MTB/RIF) (2020) or Xpert-Ultra (2021). The agreement of the individual and pooled samples was compared and the reasons for discrepant results and potential cartridge savings were assessed.<h4>Results</h4>Each survey included 436 participants, which were tested in 109 pools. In the Xpert-MTB/RIF survey, 25 (sensitivity 89%, 95% CI 72.8% to 96.3%) of 28 pools containing MTB-positive samples tested positive and 81 pools containing only MTB-negative samples tested negative (specificity 100%, 95% CI 95.5% to 100%). In the Xpert-Ultra survey, all 32 (sensitivity 100%, 95% CI 89.3% to 100%) pools containing MTB-positive samples tested positive and all 77 (specificity 100%, 95% CI 95.3% to 100%) containing only MTB-negative samples tested negative. Pooling with Xpert-MTB/RIF and Xpert-Ultra saved 52% and 46% (227/436 and 199/436, respectively) of cartridge costs alone.<h4>Conclusion</h4>Testing single and pooled specimens had a high level of agreement, with complete concordance when using Xpert-Ultra. Pooling samples could generate significant cartridge savings during ACF campaigns.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | Xpert MTB, RIF, Xpert Ultra, pooling, pooled testing, active case finding |
| Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Infection, Veterinary and Ecological Sciences |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 20 Jan 2023 10:05 |
| Last Modified: | 06 Apr 2023 10:02 |
| DOI: | 10.1136/bmjgh-2021-007592 |
| Open Access URL: | http://dx.doi.org/10.1136/bmjgh-2021-007592 |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3167185 |
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