Impact of the Xpert MTB/RIF diagnostic test for tuberculosis in countries with a high burden of disease

Current Opinion in Pulmonary Medicine
R McNerney, Alimuddin Zumla

Abstract

Control of tuberculosis necessitates prompt diagnosis and access to effective treatment. We discuss the impact of a new nucleic acid amplification test to assist diagnosis and detect rifampicin resistance. Following encouraging clinical performance studies, an automated PCR-based test, the Xpert MTB/RIF (Cepheid, Sunnyvale, CA), has been implemented on a global scale. Clinical trials to assess the impact of the new technology in primary healthcare clinics have been undertaken in tuberculosis (TB) endemic countries. Clinical trials at the point of care in TB endemic countries demonstrated that increased numbers of TB patients are identified using the Xpert MTB/RIF assay as the frontline diagnostic test in place of sputum smear microscopy. Decreased times from sample collection to initiation of treatment were also reported when using the molecular test. However, overall case notification rates did not improve, and no significant impact on patient outcome (morbidity or mortality) was reported. Sensitive molecular tests to assist diagnosis of tuberculosis may provide a faster diagnostic result when used in clinics and laboratories, but the limited impact on patient outcomes suggests additional interventions are needed to enhance TB...Continue Reading

References

Sep 10, 2010·The New England Journal of Medicine·Catharina C BoehmeMark D Perkins
Feb 18, 2011·Nature Reviews. Microbiology·Ruth McNerney, Peter Daley
Nov 2, 2012·Scandinavian Journal of Infectious Diseases·Frauke RudolfChristian Wejse
Mar 28, 2013·The Lancet Infectious Diseases·Stephen D LawnAlimuddin Zumla
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Dec 10, 2014·The Pan African Medical Journal·Saddiq Tsimiri AbdurrahmanLuis Eduardo Cuevas

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Citations

Sep 27, 2015·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Ruth McNerney, Rosanna W Peeling
Sep 27, 2015·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Marco SchitoAlimuddin Zumla
Sep 25, 2019·Nature Reviews. Urology·Asif MuneerAlimuddin Zumla
Mar 19, 2015·Current Opinion in Pulmonary Medicine·Alimuddin Zumla, Michael S Niederman
Apr 21, 2018·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·Mitsuko SekiSatoshi Mitarai
Aug 9, 2017·African Journal of Laboratory Medicine·Ishani PathmanathanHeather Alexander
May 11, 2021·Respiratory Medicine and Research·T MaitreN Veziris

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Methods Mentioned

BETA
nucleic acid amplification

Software Mentioned

GeneXpert

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