Evidence map›Paper›PMID 29208074›Full record

ArticleEpidemiology and infection2018

The impact of implementing a Xpert MTB/RIF algorithm on drug-sensitive pulmonary tuberculosis: a retrospective analysis.

K Rees, N Muditambi, M Maswanganyi, J Railton, J A McIntyre, H E Struthers, P B Fourie, R P H Peters

Open access · bronzeAbstract read
In one paragraph

Article in Epidemiology and infection, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 2 pooled it
0.3field-weighted citation impact, top 39% 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

5 citing papers in PubMed, 2 syntheses or guidelines pooled it, 4 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
  5. Article
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

8 authors at 3 institutions in 2 countries.

K ReesAnova Health Institute,Johannesburg,South Africa.
N MuditambiAnova Health Institute,Johannesburg,South Africa.
M MaswanganyiMopani Department of Health,Giyani,South Africa.
J RailtonAnova Health Institute,Johannesburg,South Africa.
J A McIntyreAnova Health Institute,Johannesburg,South Africa.
H E StruthersAnova Health Institute,Johannesburg,South Africa.
P B FourieDepartment of Medical Microbiology,University of Pretoria,Pretoria,South Africa.
R P H PetersAnova Health Institute,Johannesburg,South Africa.
Anova Health Institute · ZAUniversity of Cape Town · ZAUniversity of Pretoria · ZA

Funding

PEPFAR
6 · The paper itself

Abstract

Xpert MTB/RIF (Xpert) is the preferred first-line test for all persons with tuberculosis (TB) symptoms in South Africa in line with a diagnostic algorithm. This study evaluates pre- and post-implementation trends in diagnostic practices for drug-sensitive, pulmonary TB in adults in an operational setting, following the introduction of the Xpert-based algorithm. We retrospectively analysed data from the national TB database for Greater Tzaneen sub-district, Limpopo Province. Trends in a number of cases, diagnosis and outcome and characteristics associated with death are reported. A total of 8407 cases were treated from 2008 until 2015, with annual cases registered decreasing by 31·7% over that time period (from 1251 to 855 per year). After implementation of Xpert, 69·9% of cases were diagnosed by Xpert, 29·4% clinically, 0·6% by smear microscopy and 0·1% by culture. Cases with a recorded microbiological test increased from 76·2% to 96·4%. Cases started on treatment without confirmation, but with a negative microbiological test increased from 7·1% to 25·7%. Case fatality decreased from 15·0% to 9·8%, remaining consistently higher in empirically treated groups, regardless of HIV status. Implementation of the algorithm coincided with a reduced number of TB cases treated and improved coverage of microbiological testing; however, a substantial proportion of cases continued to start treatment empirically.

Indexed as

AlgorithmsAdolescentAdultAgedAged, 80 and overDNA, BacterialFemaleHumansMaleMicroscopyMiddle AgedMultivariate AnalysisMycobacterium tuberculosisNucleic Acid Amplification TechniquesRetrospective StudiesSouth AfricaDNA, BacterialDiagnostic trendHIVtuberculosisXpert

Identifiers

PMID29208074
PMCPMC9134741
OpenAlexW2772534668

What OpenQuestion holds

Textmetadata
Read underepoch 390

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.