ArticleBMC infectious diseases2014
Effects of introducing Xpert MTB/RIF test on multi-drug resistant tuberculosis diagnosis in KwaZulu-Natal South Africa.
Article in BMC infectious diseases, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 4 of them syntheses that pooled it.
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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.
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Who cites it
24 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Pretreatment attrition after rifampicin-resistant tuberculosis diagnosis with Xpert MTB/RIF or ultra in high TB burden countries: a systematic review and meta-analysis.BMJ global health · 2025Pooled 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 Point-of-Care Xpert MTB/RIF on Tuberculosis Treatment Initiation. A Cluster-randomized Trial.American journal of respiratory and critical care medicine · 2017Trial
- National Implementation of a Tuberculosis Sample Referral Network to Expand Access to Molecular Diagnosis in the Republic of Congo: Pilot Evaluation and Programmatic Analysis (2023-2025).Tropical medicine and infectious disease · 2026Article
- Risk factors for diagnosis and treatment delay among patients with multidrug-resistant tuberculosis in Hunan Province, China.BMC infectious diseases · 2024Article
- Performance of Xpert MTB/RIF and sputum microscopy compared to sputum culture for diagnosis of tuberculosis in seven hospitals in Indonesia.Frontiers in medicine · 2022Article
- Decentralized Care for Rifampin-Resistant Tuberculosis, Western Cape, South Africa.Emerging infectious diseases · 2021Review
- 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
- Impact of GxAlert on the management of rifampicin-resistant tuberculosis patients, Port Moresby, Papua New Guinea.Public health action · 2019Article
- Using national laboratory data to assess cumulative frequency of linkage after transfer to community-based HIV clinics in South Africa.Journal of the International AIDS Society · 2019Article
- Assessing the completeness and accuracy of South African National Laboratory CD4 and viral load data: a cross-sectional study.BMJ open · 2018Article
- Delay and attrition before treatment initiation among MDR-TB patients in five districts of Gujarat, India.Public health action · 2018Article
- The California Multidrug-Resistant Tuberculosis Consult Service: a partnership of state and local programs.Public health action · 2018Article
- Comparison of line probe assay to BACTEC MGIT 960 system for susceptibility testing of first and second-line anti-tuberculosis drugs in a referral laboratory in South Africa.BMC infectious diseases · 2017Article
- Mycobacterial genomic DNA from used Xpert MTB/RIF cartridges can be utilised for accurate second-line genotypic drug susceptibility testing and spoligotyping.Scientific reports · 2017Article
- Implications of Failure to Routinely Diagnose Resistance to Second-Line Drugs in Patients With Rifampicin-Resistant Tuberculosis on Xpert MTB/RIF: A Multisite Observational Study.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2017Observational
- Time to Drug-Resistant Tuberculosis Treatment in a Prospective South African Cohort.Global pediatric health · 2017Article
- Impact of the GeneXpert MTB/RIF Technology on Tuberculosis Control.Microbiology spectrum · 2017Review
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAn algorithm instituted following Xpert MTB/RIF (Xpert) introduction in South Africa advocates for treating all Xpert rifampicin resistant patients as MDR-TB cases while awaiting confirmation by phenotypic or genotypic drug susceptibility testing. This study evaluates how the Xpert has influenced the diagnosis and management of drug resistant TB in the highest burdened district of KwaZulu-Natal Province.
methodsData was retrospectively collected from all patients with rifampicin resistance on Xpert performed between March 2011 and April 2012. Xpert results were compared with those of phenotypic and/genotypic drug susceptibility testing. Patients' records were used to determine the time to treatment initiation.
resultsOut of 637 patients tested by Xpert, 50% had confirmatory results, of which a third were sent on the same day as Xpert test. The rate of rifampicin discordance and monoresistance was 8.8% and 13.4% respectively and there was no difference between phenotypic and genotypic confirmation. Among those who had been initiated on treatment, 28%, 40%, 21% and 8% of patients commenced within 2 weeks, 1 month, 2 months and 3 months of Xpert testing respectively, while the remaining 3% were observed without treatment.
conclusionThis study emphasizes the importance of complying with the algorithm in confirming all Xpert rif resistant cases so as to ensure proper management of these patients. Despite the rapidity of the Xpert results, only about 70% of patients had been initiated treatment at one month. Therefore there is a definite need to improve the health systems in order to improve on these delays.
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