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Has universal screening with Xpert® MTB/RIF increased the proportion of multidrug-resistant tuberculosis cases diagnosed in a routine operational setting?

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  • Pren Naidoo
  • Rory Dunbar
  • Judy Caldwell
  • Carl Lombard
  • Nulda Beyers

Abstract

Setting: Primary health services in Cape Town, South Africa where the introduction of Xpert® MTB/RIF (Xpert) enabled simultaneous screening for tuberculosis (TB) and drug susceptibility in all presumptive cases. Study aim: To compare the proportion of TB cases with drug susceptibility tests undertaken and multidrug-resistant tuberculosis (MDR-TB) diagnosed pre-treatment and during the course of 1st line treatment in the previous smear/culture and the newly introduced Xpert-based algorithms. Methods: TB cases identified in a previous stepped-wedge study of TB yield in five sub-districts over seven one-month time-points prior to, during and after the introduction of the Xpert-based algorithm were analysed. We used a combination of patient identifiers to identify all drug susceptibility tests undertaken from electronic laboratory records. Differences in the proportions of DST undertaken and MDR-TB cases diagnosed between algorithms were estimated using a binomial regression model. Results: Pre-treatment, the probability of having a DST undertaken (RR = 1.82)(p

Suggested Citation

  • Pren Naidoo & Rory Dunbar & Judy Caldwell & Carl Lombard & Nulda Beyers, 2017. "Has universal screening with Xpert® MTB/RIF increased the proportion of multidrug-resistant tuberculosis cases diagnosed in a routine operational setting?," PLOS ONE, Public Library of Science, vol. 12(2), pages 1-14, February.
    • Handle: RePEc:plo:pone00:0172143
    DOI: 10.1371/journal.pone.0172143
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