ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2013
Implementation of genotype MTBDRplus reduces time to multidrug-resistant tuberculosis therapy initiation in South Africa.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03356925 (Feasibility, Accuracy, and Effect of Point-of-care Xpert MTB/RIF Ultra and Xpert MTB/RIF Ultra Testing in Patients Suspected of Having TB), which is not on this map. Cited by 59 papers, 8 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Feasibility, Accuracy, and Effect of Point-of-care Xpert MTB/RIF Ultra and Xpert MTB/RIF Ultra Testing in Patients Suspected of Having TB: a Randomised Controlled Trial
Who cites it
59 citing papers in PubMed, 8 syntheses or guidelines pooled it, 96 citations in OpenAlex.
- Impact of molecular diagnostic tests on diagnostic and treatment delays in tuberculosis: a systematic review and meta-analysis.BMC infectious diseases · 2022Pooled it
- High resolution melting assay as a reliable method for diagnosing drug-resistant TB cases: a systematic review and meta-analysis.BMC infectious diseases · 2021Pooled it
- Factors influencing diagnosis and treatment initiation for multidrug-resistant/rifampicin-resistant tuberculosis in six sub-Saharan African countries: a mixed-methods systematic review.BMJ global health · 2020Pooled it
- Time to treatment for rifampicin-resistant tuberculosis: systematic review and meta-analysis.The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2017Pooled it
- Barriers to initiating tuberculosis treatment in sub-Saharan Africa: a systematic review focused on children and youth.Global health action · 2017Pooled it
- Impact of Molecular Diagnostics for Tuberculosis on Patient-Important Outcomes: A Systematic Review of Study Methodologies.PloS one · 2016Pooled it
- Systematic review of allelic exchange experiments aimed at identifying mutations that confer drug resistance in Mycobacterium tuberculosis.The Journal of antimicrobial chemotherapy · 2014Pooled it
- Meta-narrative review of molecular methods for diagnosis and monitoring of multidrug-resistant tuberculosis treatment in adults.International journal of mycobacteriologyPooled it
- Clinical Impact of the Line Probe Assay and Xpert® MTB/RIF Assay in the Presumptive Diagnosis of Drug-Resistant Tuberculosis in Brazil: A Pragmatic Clinical Trial.Revista da Sociedade Brasileira de Medicina Tropical · 2022Trial
- Trial
- Uptake and rollout of the World Health Organization-endorsed technologies for Tuberculosis diagnosis in Africa: a literature review of international evidence 2007-2021.African health sciences · 2025Review
- Nationwide coverage of molecular drug susceptibility testing in patients with pulmonary multidrug/rifampicin-resistant tuberculosis in South Korea: a retrospective cohort study (2015-2021).BMJ open respiratory research · 2025Article
- Surviving Bad News: Health Information Without Treatment Options.American economic review. Insights · 2025Article
- Trends and forecast of drug-resistant tuberculosis: a global perspective from the GBD study 2021.Frontiers in public health · 2025Article
- Time-to-Treatment Initiation in a Decentralised Community-Care Model of Drug-Resistant Tuberculosis Management in the OR Tambo District Municipality of South Africa.International journal of environmental research and public health · 2023Article
- Profile and Frequency of Mutations Conferring Drug-Resistant Tuberculosis in the Central, Southeastern and Eastern Ethiopia.Infection and drug resistance · 2023Article
- Rifampicin resistance inNew microbes and new infections · 2021Article
- Ease and equity of access to free DR-TB services in Nigeria- a qualitative analysis of policies, structures and processes.International journal for equity in health · 2020Article
- Isoniazid Preventive Therapy in Contacts of Multidrug-Resistant Tuberculosis.American journal of respiratory and critical care medicine · 2020Article
- Impact of Molecular Drug Susceptibility Testing on the Time to Multidrug-resistant Tuberculosis Treatment Initiation.Journal of Korean medical science · 2020Article
Corrections and comments
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Authors and funding
10 authors at 7 institutions in 3 countries.
Funding
Abstract
backgroundDiagnosis of drug resistance and timely initiation of multidrug-resistant (MDR) tuberculosis therapy are essential to reduce transmission and improve patient outcomes. We sought to determine whether implementation of the rapid MTBDRplus diagnostic shortened the time from specimen collection to patient MDR tuberculosis therapy initiation.
methodsWe conducted a retrospective cohort analysis of 197 MDR tuberculosis patients treated at Brewelskloof, a rural tuberculosis hospital in Western Cape Province, South Africa, between 2007 and 2011.
resultsEighty-nine patients (45%) were tested using conventional liquid culture and drug susceptibility testing (DST) on solid medium and 108 (55%) were tested using the MTBDRplus assay after positive acid-fast bacilli or culture. Median time from sample taken to therapy initiation was reduced from 80 days (interquartile range [IQR] 62-100) for conventional DST to 55 days (IQR 37.5-78) with the MTBDRplus. Although the laboratory processing time declined significantly, operational delays persisted both in the laboratory and the clinical infrastructure for getting patients started on treatment. In multivariate analysis, patients tested using the MTBDRplus test had a reduced risk of starting treatment 60 days or more after sputum collection of 0.52 (P < .0001) compared with patients tested with culture-based DST, after adjustment for smear status and site of disease.
conclusionsUse of MTBDRplus significantly reduced time to MDR tuberculosis treatment initiation. However, DST reporting to clinics was delayed by more than 1 week due, in part, to laboratory operational delays, including dependence on smear and culture positivity prior to MTBDRplus performance. In addition, once MDR tuberculosis was reported, delays in contacting patients and initiating therapy require improvements in clinical infrastructure.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.