The effect of sputum quality and volume on the yield of bacteriologically-confirmed TB by Xpert MTB/RIF and smear
INTRODUCTION: The World Health Organization endorsed (2010) the use of Xpert MTB/RIF and countries are shifting from smear microscopy (smear)-based to Xpert MTB/RIF-based tuberculosis (TB) diagnostic algorithms. As with smear, sputum quality may predict the likelihood of obtaining a bacteriologicall...
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| Format: | Article |
| Language: | English |
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The Pan African Medical Journal
2019-06-01
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| Series: | The Pan African Medical Journal |
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https://www.panafrican-med-journal.com/content/article/33/110/pdf/110.pdf
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| _version_ | 1819001533761585152 |
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| author | Onani Zimba Tsaone Tamuhla Joyce Basotli Gaoraelwe Letsibogo Sherri Pals Unami Mathebula Anikie Mathoma Christopher Serumola Kitso Ramogale Rosanna Boyd Tiffany Tran Alyssa Finlay Andrew Auld Anand Date Heather Alexander Violet Chihota Tefera Agizew |
| author_facet | Onani Zimba Tsaone Tamuhla Joyce Basotli Gaoraelwe Letsibogo Sherri Pals Unami Mathebula Anikie Mathoma Christopher Serumola Kitso Ramogale Rosanna Boyd Tiffany Tran Alyssa Finlay Andrew Auld Anand Date Heather Alexander Violet Chihota Tefera Agizew |
| author_sort | Onani Zimba |
| collection | DOAJ |
| description | INTRODUCTION: The World Health Organization endorsed (2010) the use of Xpert MTB/RIF and countries are shifting from smear microscopy (smear)-based to Xpert MTB/RIF-based tuberculosis (TB) diagnostic algorithms. As with smear, sputum quality may predict the likelihood of obtaining a bacteriologically-confirmed TB when using Xpert MTB/RIF. METHODS: From 08/12-11/2014, all people living with HIV were recruited at 22 clinics. For patients screened positive using the four TB symptoms their sputa were tested by Xpert MTB/RIF and smear. Laboratorians assessed and recorded sputum appearance and volume. The yield of bacteriologically-positive sputum evaluated using Xpert MTB/RIF and smear, likelihood-ratios were calculated. RESULTS: Among 6,041 patients enrolled 2,296 were presumptive TB, 1,305 (56.8%) had 1 sputa collected and 644/1,305 (49.3%) had both Xpert MTB/RIF and smear results. Since 1 sputa collected from 644 patients 954 sputa were tested by Xpert MTB/RIF and smear. Bacteriologically-positive sputum was two-fold higher with Xpert MTB/RIF 11.4% versus smear 5.3%, p = 0.001. Sputum appearance and quantity were not predictive of bacteriologically-positive results, except volume of 2ml to 3ml, tested by Xpert MTB/RIF LR+=1.26 (95% CI, 1.05,1.50). CONCLUSION: Xpert MTB/RIF test yield to bacteriologically-positive sputum was superior to smear. Sputum quality and quantity, however, were not consistently predictive of bacteriologically-positive results by Xpert MTB/RIF or smear. |
| first_indexed | 2024-12-20T22:50:44Z |
| format | Article |
| id | doaj.art-52ccba4885374c6380b8009999c2fa91 |
| institution | Directory Open Access Journal |
| issn | 1937-8688 1937-8688 |
| language | English |
| last_indexed | 2024-12-20T22:50:44Z |
| publishDate | 2019-06-01 |
| publisher | The Pan African Medical Journal |
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| series | The Pan African Medical Journal |
| spelling | doaj.art-52ccba4885374c6380b8009999c2fa912022-12-21T19:24:16ZengThe Pan African Medical JournalThe Pan African Medical Journal1937-86881937-86882019-06-013311010.11604/pamj.2019.33.110.1531915319The effect of sputum quality and volume on the yield of bacteriologically-confirmed TB by Xpert MTB/RIF and smearOnani Zimba0Tsaone Tamuhla1Joyce Basotli2Gaoraelwe Letsibogo3Sherri Pals4Unami Mathebula5Anikie Mathoma6Christopher Serumola7Kitso Ramogale8Rosanna Boyd9Tiffany Tran10Alyssa Finlay11Andrew Auld12Anand Date13Heather Alexander14Violet Chihota15Tefera Agizew16 Centers for Disease Control and Prevention, Botswana Botswana University of Pennsylvania, Botswana Centers for Disease Control and Prevention, Botswana National Tuberculosis reference Laboratory, Ministry of Health and Wellness, BotswanDivision of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Atlanta, Georgia, United Statesof AmericaDivision of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta Georgia, United States of America The Aurum Institute, Johannesburg, South Africa Centers for Disease Control and Prevention, Botswana Centers for Disease Control and Prevention, Botswana Centers for Disease Control and Prevention, Botswana Botswana University of Pennsylvania, Botswana Centers for Disease Control and Prevention, Botswana Centers for Disease Control and Prevention, Botswana Centers for Disease Control and Prevention, Botswana The Aurum Institute, Johannesburg, South Africa The Aurum Institute, Johannesburg, South Africa The Aurum Institute, Johannesburg, South Africa University Department of Family Medicine and Public Health, Faculty of Medicine, University of Botswana, Botswana Centers for Disease Control and Prevention, Botswana INTRODUCTION: The World Health Organization endorsed (2010) the use of Xpert MTB/RIF and countries are shifting from smear microscopy (smear)-based to Xpert MTB/RIF-based tuberculosis (TB) diagnostic algorithms. As with smear, sputum quality may predict the likelihood of obtaining a bacteriologically-confirmed TB when using Xpert MTB/RIF. METHODS: From 08/12-11/2014, all people living with HIV were recruited at 22 clinics. For patients screened positive using the four TB symptoms their sputa were tested by Xpert MTB/RIF and smear. Laboratorians assessed and recorded sputum appearance and volume. The yield of bacteriologically-positive sputum evaluated using Xpert MTB/RIF and smear, likelihood-ratios were calculated. RESULTS: Among 6,041 patients enrolled 2,296 were presumptive TB, 1,305 (56.8%) had 1 sputa collected and 644/1,305 (49.3%) had both Xpert MTB/RIF and smear results. Since 1 sputa collected from 644 patients 954 sputa were tested by Xpert MTB/RIF and smear. Bacteriologically-positive sputum was two-fold higher with Xpert MTB/RIF 11.4% versus smear 5.3%, p = 0.001. Sputum appearance and quantity were not predictive of bacteriologically-positive results, except volume of 2ml to 3ml, tested by Xpert MTB/RIF LR+=1.26 (95% CI, 1.05,1.50). CONCLUSION: Xpert MTB/RIF test yield to bacteriologically-positive sputum was superior to smear. Sputum quality and quantity, however, were not consistently predictive of bacteriologically-positive results by Xpert MTB/RIF or smear. https://www.panafrican-med-journal.com/content/article/33/110/pdf/110.pdf molecular diagnostic yieldsputum qualitybotswana |
| spellingShingle | Onani Zimba Tsaone Tamuhla Joyce Basotli Gaoraelwe Letsibogo Sherri Pals Unami Mathebula Anikie Mathoma Christopher Serumola Kitso Ramogale Rosanna Boyd Tiffany Tran Alyssa Finlay Andrew Auld Anand Date Heather Alexander Violet Chihota Tefera Agizew The effect of sputum quality and volume on the yield of bacteriologically-confirmed TB by Xpert MTB/RIF and smear The Pan African Medical Journal molecular diagnostic yield sputum quality botswana |
| title | The effect of sputum quality and volume on the yield of bacteriologically-confirmed TB by Xpert MTB/RIF and smear |
| title_full | The effect of sputum quality and volume on the yield of bacteriologically-confirmed TB by Xpert MTB/RIF and smear |
| title_fullStr | The effect of sputum quality and volume on the yield of bacteriologically-confirmed TB by Xpert MTB/RIF and smear |
| title_full_unstemmed | The effect of sputum quality and volume on the yield of bacteriologically-confirmed TB by Xpert MTB/RIF and smear |
| title_short | The effect of sputum quality and volume on the yield of bacteriologically-confirmed TB by Xpert MTB/RIF and smear |
| title_sort | effect of sputum quality and volume on the yield of bacteriologically confirmed tb by xpert mtb rif and smear |
| topic | molecular diagnostic yield sputum quality botswana |
| url |
https://www.panafrican-med-journal.com/content/article/33/110/pdf/110.pdf
|
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