Evidence map›Paper›PMID 27287639›Full record

ArticleThe international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease2016

Xpert(®) MTB/RIF detection of rifampin resistance and time to treatment initiation in Harare, Zimbabwe.

J Z Metcalfe, S Makumbirofa, B Makamure, C Sandy, W Bara, P Mason, P C Hopewell

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PubMed Full text at PMC Publisher
In one paragraph

Article in The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
16citing papers in PubMed, 6 pooled it
2.5field-weighted citation impact, top 12% of its field
1 · What the graph read from it

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

16 citing papers in PubMed, 6 syntheses or guidelines pooled it, 23 citations in OpenAlex.

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  7. Distribution and frequency of common mutations inJournal of clinical tuberculosis and other mycobacterial diseases · 2022
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

J Z MetcalfeCurry International Tuberculosis Center, Division of Pulmonary and Critical Care Medicine, San Francisco General Hospital, University of California, San Francisco, California, USA.
S MakumbirofaBiomedical Research & Training Institute, Harare, Zimbabwe.
B MakamureBiomedical Research & Training Institute, Harare, Zimbabwe.
C SandyNational Tuberculosis Control Program, Harare, Zimbabwe.
W BaraHarare City Health Department, Harare, Zimbabwe.
P MasonBiomedical Research & Training Institute, Harare, University of Zimbabwe College of Health Sciences, Harare, Zimbabwe.
P C HopewellCurry International Tuberculosis Center, Division of Pulmonary and Critical Care Medicine, San Francisco General Hospital, University of California, San Francisco, California, USA.
Biomedical Research and Training Institute · ZWNational Blood Service Zimbabwe · ZW

Funding

Improving Early Identification of Drug Resistant Tuberculosis in HIV Prevalent SeK23AI094251 · NIAID · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI METCALFE, JOHN ZAPATA · 2011 to 2015
$625k
NIAID NIH HHS K23 AI094251
6 · The paper itself

Abstract

backgroundPatients at elevated risk of drug-resistant tuberculosis (TB) are prioritized for Xpert(®) MTB/RIF testing; however, the clinical usefulness of the test in this population is understudied.

designFrom November 2011 to June 2014, consecutive out-patients with a history of previous TB in high-density suburbs of Harare, Zimbabwe, were tested using Xpert, solid and liquid culture, and the microscopic observation drug susceptibility assay. Diagnostic accuracy for rifampin (RMP) resistance and time to initiation of second-line regimens were ascertained. The rpoB gene was sequenced in cases with culture-confirmed RMP resistance and genotypic susceptibility.

resultsAmong 352 retreatment patients, 71 (20%) were RMP-resistant, 98 (28%) RMP-susceptible, 64 (18%) culture-negative/Xpert-positive, and 119 (34%) culture-negative/Xpert-negative. Xpert had a sensitivity of 86% (95%CI 75-93) and a specificity of 98% (95%CI 92-100) for RMP-resistant TB. The positive predictive value of Xpert-determined RMP resistance for multidrug-resistant TB (MDR-TB) was 82% (95%CI 70-91). Of 71 (83%) participants, 59 initiated treatment with second-line drugs, with a median time to treatment initiation of 18 days (IQR 10-44).

conclusionThe diagnostic accuracy of Xpert for RMP resistance is high, although the predictive value for MDR-TB was lower than anticipated. Xpert allows for faster initiation of second-line treatment than culture-based drug susceptibility testing under programmatic conditions.

Indexed as

DNA Mutational AnalysisMolecular Diagnostic TechniquesMutationTime-to-TreatmentAdultAntitubercular AgentsBacterial ProteinsDNA-Directed RNA PolymerasesDrug Resistance, BacterialFemaleHumansMaleMiddle AgedMycobacterium tuberculosisPredictive Value of TestsProspective StudiesAntitubercular AgentsBacterial ProteinsDNA-Directed RNA PolymerasesRifampinrpoB protein, Mycobacterium tuberculosis

Identifiers

PMID27287639
PMCPMC4961684
OpenAlexW2412236122

What OpenQuestion holds

Textmetadata
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Registered trials

None linked

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.