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The Application of GeneXpert MTB/RIF for Smear-Negative TB Diagnosis as a Fee-Paying Service at a South Asian General Hospital

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Shrestha, Poojan, Arjyal, Amit, Caws, Maxine ORCID: https://orcid.org/0000-0002-9109-350X, Prajapati, Krishna Govinda, Karkey, Abhilasha, Dongol, Sabina, Pathak, Saruna, Prajapati, Shanti and Basnyat, Buddha (2015) 'The Application of GeneXpert MTB/RIF for Smear-Negative TB Diagnosis as a Fee-Paying Service at a South Asian General Hospital'. Tuberculosis Research and Treatment, Vol 2015.

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Abstract

The GeneXpert MTB/RIF assay (Xpert) is a novel automated diagnostic tool for tuberculosis but its optimal placement in the healthcare system has not been determined. The objective of this study was to determine the possibility of additional case detection for pulmonary tuberculosis (PTB) by offering Xpert to smear-negative patients in a low-HIV burden setting with no Mycobacterium tuberculosis (M.tb.) culture facilities. Patients routinely presenting with symptoms suggestive of PTB with negative smears were offered single Xpert test on a fee-paying basis. Data were retrospectively reviewed to determine case detection in patients tested from February to December 2013. Symptoms associated with a positive test were analysed to determine if refinement of clinical criteria would reduce unnecessary testing. 258 smear-negative patients were included and M.tb. was detected in 55 (21.32%, n = 55/258). Using standard clinical assessment for selection, testing 5 patients detected one case of smear-negative PTB. These results demonstrate that fee-paying Xpert service in low-income setting can increase TB case confirmation substantially and further systematic studies of health economic implications should be conducted to determine optimal implementation models to increase access to Xpert in low- and middle-income countries.

Item Type: Article
Subjects: WB Practice of Medicine > Diagnosis > General Diagnosis > WB 141 General works
WF Respiratory System > Tuberculosis > WF 200 Tuberculosis (General)
WF Respiratory System > Tuberculosis > WF 220 Diagnosis. Prognosis
WF Respiratory System > Tuberculosis > WF 300 Pulmonary tuberculosis
Faculty: Department: Clinical Sciences & International Health > Clinical Sciences Department
Clinical Sciences & International Health > International Public Health Department
Digital Object Identifer (DOI): https://doi.org/10.1155/2015/102430
Depositing User: Jessica Jones
Date Deposited: 10 Feb 2016 11:01
Last Modified: 06 Feb 2018 13:11
URI: https://archive.lstmed.ac.uk/id/eprint/5641

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