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

Pren Naidoo, Rory Dunbar, Judy Caldwell, Carl Lombard and Nulda Beyers

PLOS ONE, 2017, vol. 12, issue 2, 1-14

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

Date: 2017
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0172143

DOI: 10.1371/journal.pone.0172143

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