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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Xpert® MTB/RIF for national tuberculosis programmes in low-income countries: When, where and how?
International Journal of Tuberculosis and Lung Disease, Volume 15, No. 12, Year 2011
Notification
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Description
Xpert® MTB/RIF offers new and important possibilities for the diagnosis of sputum smear-negative tuberculosis (TB) and/or rifampicin (RMP) resistance, and many are encouraging rapid and widespread implementation. This simple test can be implemented almost everywhere, and it provides results within a few hours. In low-income countries (LICs), however, its cost, environmental limitations (stable and regular electricity, adequate room temperature) and difficulties involved in supply and maintenance are major obstacles. While it may be suitable for major reference hospitals, operational research is needed to evaluate the test and its additional yield above high-quality smear microscopy and clinical algorithms before its use at the peripheral level. In the meantime, direct microscopy should remain the initial diagnostic test for TB suspects. In most LICs, the prevalence of RMP resistance among new TB patients is very low; an Xpert MTB/RIF result indicating RMP resistance will thus always need confirmation by another test. In a population at high risk of RMP resistance (>15%), however, the positive predictive value for RMP resistance by Xpert MTB/RIF is high, and identification of RMP resistance is an excellent proxy for multidrug-resistant TB (MDR-TB). The assay should be widely used for this purpose if, and only if, excellent MDR-TB management is available, both for ethical reasons and to reduce the risk of extensively drug-resistant TB. © 2011 The Union.
Authors & Co-Authors
Trébucq, Arnaud
France, Paris
International Union Against Tuberculosis and Lung Disease
Enarson, Donald A.
France, Paris
International Union Against Tuberculosis and Lung Disease
Chiang, Chenyuan
France, Paris
International Union Against Tuberculosis and Lung Disease
van Deun, Armand
France, Paris
International Union Against Tuberculosis and Lung Disease
Harries, Anthony David
France, Paris
International Union Against Tuberculosis and Lung Disease
Boillot, François
France, Paris
International Union Against Tuberculosis and Lung Disease
Detjen, Anne K.
France, Paris
International Union Against Tuberculosis and Lung Disease
Fujiwara, Paula Isono
France, Paris
International Union Against Tuberculosis and Lung Disease
Graham, Stephen Michael
France, Paris
International Union Against Tuberculosis and Lung Disease
Monedero-Recuero, Ignacio
France, Paris
International Union Against Tuberculosis and Lung Disease
Rusen, I. D.
France, Paris
International Union Against Tuberculosis and Lung Disease
Rieder, Hans L.
France, Paris
International Union Against Tuberculosis and Lung Disease
Statistics
Citations: 116
Authors: 12
Affiliations: 1
Identifiers
Doi:
10.5588/ijtld.11.0392
ISSN:
10273719
Research Areas
Infectious Diseases
Study Design
Cross Sectional Study