Trial reportPloS one2015
Missed Opportunities for TB Investigation in Primary Care Clinics in South Africa: Experience from the XTEND Trial.
Trial report in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03044158 (GeneXpert Performance Evaluation for Linkage to Tuberculosis Care), which is not on this map. Cited by 35 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
GeneXpert Performance Evaluation for Linkage to Tuberculosis Care: The XPEL-TB Trial
Who cites it
35 citing papers in PubMed.
- Multicomponent Strategy with Decentralized Molecular Testing for Tuberculosis.The New England journal of medicine · 2021Trial
- Organizational contextual factors that predict success of a quality improvement collaborative approach to enhance integrated HIV-tuberculosis services: a sub-study of the Scaling up TB/HIV Integration trial.Implementation science : IS · 2021Trial
- A cluster-randomized controlled trial to improve the quality of integrated HIV-tuberculosis services in primary healthcareclinics in South Africa.Journal of the International AIDS Society · 2021Trial
- Computer-aided X-ray screening for tuberculosis and HIV testing among adults with cough in Malawi (the PROSPECT study): A randomised trial and cost-effectiveness analysis.PLoS medicine · 2021Trial
- Effect of tuberculosis screening and retention interventions on early antiretroviral therapy mortality in Botswana: a stepped-wedge cluster randomized trial.BMC medicine · 2020Trial
- Implementation of a pragmatic, stepped-wedge cluster randomized trial to evaluate impact of Botswana's Xpert MTB/RIF diagnostic algorithm on TB diagnostic sensitivity and early antiretroviral therapy mortality.BMC infectious diseases · 2016Trial
- Trial
- Towards ending tuberculosis in South Africa: an uncertainty analysis of the programmes and factors most critical to future declines.Global health action · 2026Article
- Estimating the number of incorrect tuberculosis diagnoses in low- and middle-income countries.Nature medicine · 2026Article
- Factors Associated With Low Tuberculosis Case Detection and Investigation in Public Health Facilities (PHFs) in Bududa District, Uganda: A Cross-Sectional Study.Health science reports · 2025Article
- Missed opportunities for TB diagnostic testing among people living with HIV in Zimbabwe: Cross-sectional analysis of the Zimbabwe Population-based HIV Impact Assessment (ZIMPHIA) survey 2015-16.Journal of clinical tuberculosis and other mycobacterial diseases · 2024Article
- Yield of Facility-based Targeted Universal Testing for Tuberculosis With Xpert and Mycobacterial Culture in High-Risk Groups Attending Primary Care Facilities in South Africa.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023Article
- Missed opportunities for initiation of treatment and control of hypertension among older adults in India.Preventive medicine reports · 2022Article
- Prevalence of Mycobacterium tuberculosis in Sputum and Reported Symptoms Among Clinic Attendees Compared With a Community Survey in Rural South Africa.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022Article
- Concomitant pulmonary disease is common among patients with extrapulmonary TB.The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2022Article
- Missed opportunities for diagnosis and treatment in patients with TB symptoms: a systematic review.Public health action · 2022Review
- Time to care-seeking for TB symptoms.The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2022Article
- The probability of diagnostic delays for tuberculosis and its associated risk factors in northwest Iran from 2005 to 2016: a survival analysis using tuberculosis surveillance data.Epidemiology and health · 2022Article
- Article
- Diagnosing Tuberculosis: What Do New Technologies Allow Us to (Not) Do?Respiration; international review of thoracic diseases · 2022Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
Abstract
setting40 primary health clinics (PHCs) in four provinces in South Africa, June 2012 -February 2013.
objectiveTo determine whether health care worker (HCW) practice in investigating people with TB symptoms was altered when the initial test for TB was changed from smear microscopy to Xpert MTB/RIF.
designCross-sectional substudy at clinics participating in a pragmatic cluster randomised trial, Xpert for TB: Evaluating a New Diagnostic "XTEND", which evaluated the effect of Xpert MTB/RIF implementation in South Africa.
methodsConsecutive adults exiting PHCs reporting at least one TB symptom (defined as any of cough, weight loss, night sweats and fever) were enrolled. The main outcome was the proportion who self-reported having sputum requested by HCW during the clinic encounter just completed.
results3604 adults exiting PHCs (1676 in Xpert arm, 1928 in microscopy arm) were enrolled (median age 38 years, 71.4% female, 38.8% reported being HIV-positive, 70% reported cough). For 1267 participants (35.2%) the main reason for attending the clinic was TB symptom(s). Overall 2130/3604 (59.1%) said they reported their symptom(s) to HCW. 22.7% (818/3604) reported having been asked to give sputum for TB investigation. Though participants in the Xpert vs. microscopy arm were more likely to have sputum requested by HCW, this was not significantly different: overall (26.0% [436/1676] vs 19.8% [382/1928]; adjusted prevalence ratio [aPR] 1.31, [95% CI 0.78-2.20]) and when restricted to those presenting at clinics due to symptoms (49.1% [260/530] vs 29.9% [220/737]; aPR 1.38 [0.89-2.13]) and those reporting being HIV-positive (29.4% [190/647] vs 20.8% [156/749]; aPR 1.38[0.88-2.16]). Those attending clinic due to TB symptoms, were more likely to have sputum requested if they had increasing number of symptoms; longer duration of cough, unintentional weight loss and night sweats and if they reported symptoms to HCW.
conclusionsA large proportion of people exiting PHCs reporting TB symptoms did not get tested. Implementation of Xpert MTB/RIF did not substantially change the probability of testing for TB. Better systems are needed to ensure that opportunities to identify active TB among PHC attendees are not missed.
Indexed as
Identifiers
What OpenQuestion holds
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.