ArticleTransactions of the Royal Society of Tropical Medicine and Hygiene2016
Policy to practice: impact of GeneXpert MTB/RIF implementation on the TB spectrum of care in Lilongwe, Malawi.
Article in Transactions of the Royal Society of Tropical Medicine and Hygiene, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 of them syntheses that pooled it.
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Who cites it
15 citing papers in PubMed, 2 syntheses or guidelines pooled it, 26 citations in OpenAlex.
- Rapid molecular tests for tuberculosis and tuberculosis drug resistance: a qualitative evidence synthesis of recipient and provider views.The Cochrane database of systematic reviews · 2022Pooled it
- Differential yield of universal versus selective drug susceptibility testing of patients with tuberculosis in high-burden countries: a systematic review and meta-analysis.BMJ global health · 2020Pooled it
- Test and Treat TB: a pilot trial of GeneXpert MTB/RIF screening on a mobile HIV testing unit in South Africa.BMC infectious diseases · 2019Trial
- Diagnostic Yield of Tongue Swab- Compared to Sputum-Based Molecular Testing for Tuberculosis in Four High-Burden Countries.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Article
- Identifying Gaps in Tuberculosis Preventive Care for Non-U.S.-born Persons at Community Health Clinics in the United States.Open forum infectious diseases · 2025Article
- Barriers to GeneXpert utilization for tuberculosis detection at a regional referral hospital in Malawi: a qualitative study.The Pan African medical journal · 2025Article
- Impact of a multi-disease integrated screening and diagnostic model for COVID-19, TB, and HIV in Lesotho.PLOS global public health · 2023Article
- 'If I am on ART, my new-born baby should be put on treatment immediately': Exploring the acceptability, and appropriateness of Cepheid Xpert HIV-1 Qual assay for early infant diagnosis of HIV in Malawi.PLOS global public health · 2023Article
- Linkage to care and treatment outcomes for patients diagnosed with drug-susceptible tuberculosis using Xpert MTB/RIF assay in Thaba-Tseka district in Lesotho.IJID regions · 2022Article
- Strengthening health systems to improve the value of tuberculosis diagnostics in South Africa: A cost and cost-effectiveness analysis.PloS one · 2021Article
- Diagnostic Utility and Impact on Clinical Decision Making of Focused Assessment With Sonography for HIV-Associated Tuberculosis in Malawi: A Prospective Cohort Study.Global health, science and practice · 2020Article
- Challenges with scale-up of GeneXpert MTB/RIF® in Uganda: a health systems perspective.BMC health services research · 2020Article
- Decreased risk of HIV-associated TB during antiretroviral therapy expansion in rural Eswatini from 2009 to 2016: a cohort and population-based analysis.Tropical medicine & international health : TM & IH · 2019Article
- Tubercular septal abscess in a postoperative patient: a novel entity.BMJ case reports · 2018Article
- Utilization and Clinical Value of Diagnostic Modalities for Tuberculosis in a High HIV Prevalence Setting.The American journal of tropical medicine and hygiene · 2018Article
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 2 countries.
Funding
Abstract
backgroundWhile previous research has provided evidence of the diagnostic accuracy of the GeneXpert MTB/RIF (GeneXpert), further information is needed about implementation in the real-world. This study evaluated the impact of the introduction of GeneXpert testing in a tertiary medical center according to the testing algorithm proposed by the National TB Control Program (NTP) guidelines.
methodsAll adult medicine inpatient persons with presumptive TB admitted between November 2013 and March 2014 were eligible for GeneXpert sputum testing and followed to TB treatment initiation status.
resultsWe identified 932 persons with presumptive TB, of which 307 (32.9%) were GeneXpert tested. Those tested had an average age of 40 years, 49.2% (151) were male, 34.5% (106) were HIV positive, and 84.1% (249) presented with a cough. Of those GeneXpert tested, 28/307 (9.1%) tested positive, a 55.5% increase in detection compared to smear microscopy. However, the majority (44/72, 61%) of TB diagnoses were made by other modalities and not confirmed microbiologically. Of the 58 patients recommended to start treatment and discharged from the hospital, only 23 (40%) were documented to have started treatment at regional directly observed treatment short (DOTS) centers.
conclusionsGeneXpert contributed minimally to overall TB diagnosis and the cascade of care due to implementation challenges of sputum collection, empiric treatment, and weak linkage to care between inpatient and outpatient settings.
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