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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Liquid vs. solid culture for tuberculosis: Performance and cost in a resource-constrained setting
International Journal of Tuberculosis and Lung Disease, Volume 14, No. 8, Year 2010
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Description
SETTING: National Health Laboratory Services tuberculosis (TB) laboratory, South Africa. OBJECTIVES: To compare Mycobacterium Growth Indicator Tube (MGIT) with Löwenstein-Jensen (LJ) medium with regard to Mycobacterium tuberculosis yield, time to positive culture and contamination, and to assess MGIT cost-effectiveness. DESIGN: Sputum from gold miners was cultured on MGIT and LJ. We estimated cost per culture, and, for smear-negative samples, incremental cost per additional M. tuberculosis gained with MGIT using a decision-tree model. RESULTS: Among 1267 specimens, MGIT vs. LJ gave a higher yield of mycobacteria (29.7% vs. 22.8%), higher contamination (16.7% vs. 9.3%) and shorter time to positive culture (median 14 vs. 25 days for smear-negative specimens). Among smear-negative samples that were culture-positive on MGIT but negative/contaminated on LJ, 77.3% were non-tuberculous mycobacteria (NTM). Cost per culture on LJ, MGIT and MGIT+LJ was respectively US$12.35, US$16.62 and US$19.29. The incremental cost per additional M. tuberculosis identified by standard biochemical tests and microscopic cording was respectively US$504.08 and US$328.10 using MGIT vs. LJ, or US$160.80 and US$109.07 using MGIT+LJ vs. LJ alone. CONCLUSION: MGIT gives higher yield and faster results at relatively high cost. The high proportion of NTM underscores the need for rapid speciation tests. Minimising contaminated cultures is key to cost-effectiveness. © 2010 The Union.
Authors & Co-Authors
Chihota, Violet N.
Unknown Affiliation
Grant, Alison D.
Unknown Affiliation
Fielding, Katherine Linda
Unknown Affiliation
Ndibongo, Buyiswa
Unknown Affiliation
van Zyl, Andrew
Unknown Affiliation
Muirhead, Debbie
Unknown Affiliation
Churchyard, Gavin John
Unknown Affiliation
Statistics
Citations: 7
Authors: 7
Affiliations: 3
Identifiers
ISSN:
10273719
Research Areas
Infectious Diseases
Study Locations
South Africa