ArticlePloS one2019
Evaluation of Xpert MTB-RIF guided diagnosis and treatment of rifampicin-resistant tuberculosis in Indonesia: A retrospective cohort study.
Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04208789 (Artificial Neural Network as Diagnostic Tools For Rifampicin-Resistant Tuberculosis In Indonesia), which is not on this map. Cited by 23 papers, 4 of them syntheses that pooled it.
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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.
Artificial Neural Network as Diagnostic Tools For Rifampicin-Resistant Tuberculosis In Indonesia: A Predictive Model Study and Economic Evaluation
Who cites it
23 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
- Prevalence and risk factors of malnutrition in patients with pulmonary tuberculosis: a systematic review and meta-analysis.Frontiers in medicine · 2023Pooled 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
- Xpert MTB/RIF assay for the diagnosis of rifampicin resistance in different regions: a meta-analysis.BMC microbiology · 2019Pooled it
- Drivers of drug-resistant tuberculosis treatment initiation delay at three tertiary health facilities in Uganda: A mixed-methods study.Journal of clinical tuberculosis and other mycobacterial diseases · 2026Article
- Diagnostic and treatment delays and associated factors among RR-TB patients under molecular drug susceptibility testing: a retrospective study in Guizhou Province, China.BMC infectious diseases · 2026Article
- Healthcare-seeking pathway and delay analysis of rifampicin-resistant tuberculosis patient in Southwestern China.BMC public health · 2025Article
- Management of drug-resistant tuberculosis in Indonesia: a four-year cascade of care analysis.The Lancet regional health. Southeast Asia · 2024Article
- Predictors of Death in Rifampicin Resistant Tuberculosis Patients Treated with the Short Course in Conakry, Guinea.The American journal of tropical medicine and hygiene · 2024Article
- Extensively and multidrug-resistant bacterial strains: case studies of antibiotics resistance.Frontiers in microbiology · 2024Review
- Prevalence ofJournal of clinical tuberculosis and other mycobacterial diseases · 2023Article
- Missing Cases of Bacteriologically Confirmed TB/DR-TB from the National Treatment Registers in West and North Sumatra Provinces, Indonesia.Tropical medicine and infectious disease · 2023Article
- The state of health in Indonesia's provinces, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019.The Lancet. Global health · 2022Article
- Anti-tuberculosis drug-induced liver injury in patient with hepatitis B and cirrhosis: A case report.Annals of medicine and surgery (2012) · 2022Article
- COVID-19 Pandemic Disruption on the Management of Tuberculosis Treatment in Indonesia.Journal of multidisciplinary healthcare · 2022Review
- Factors associated with treatment outcome of MDR/RR-TB patients treated with shorter injectable based regimen in West Java Indonesia.PloS one · 2022Article
- Genetic variation of ABCB1 (rs1128503, rs1045642) and CYP2E1 rs3813867 with the duration of tuberculosis therapy: a pilot study among tuberculosis patients in Indonesia.BMC research notes · 2021Article
- From infection niche to therapeutic target: the intracellular lifestyle ofMicrobiology (Reading, England) · 2021Review
- Article
- Development and performance of CUHAS-ROBUST application for pulmonary rifampicin-resistance tuberculosis screening in Indonesia.PloS one · 2021Article
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRifampicin-resistant tuberculosis (RR-TB) is largely underdetected in Indonesia. Xpert MTB/RIF (Xpert) has recently been introduced, prioritizing patients at risk of RR-TB, followed by phenotypic drug-susceptibility (DST) if rifampicin resistance is detected.
objectiveThis study investigated Xpert-based management of presumptive RR-TB cases under routine practice in West Java, Indonesia.
methodsWe examined all records of patients tested with Xpert in the referral hospital for West Java in 2015-2016. We measured loss across a limited cascade of care, time to Xpert diagnosis and the commencement of initial second-line treatment, and identified factors associated with diagnostic and treatment delay. Additionally, we analyzed the appropriateness of treatment according to DST results.
resultsOf 3415 patients with presumptive RR-TB, 3215 (94%) were tested by Xpert, of whom 339 (10.5%) were diagnosed as RR-TB. 288 (85%) of 339 RR-TB patients started initial second-line TB treatment, with 48 (14%) patients being lost between diagnosis and pre-treatment assessment. Second-line treatment was commenced at a median of 41 days (IQR 29-70) after RR-TB diagnosis. Delays in both diagnosis and treatment initiation were observed in 104 (52%) of 201 RR-TB patients with identifiable referral date. Rural residence was associated with delay to diagnosis (adjusted OR 2.7; 95%CI 1.5-5.2) and treatment initiation (adjusted OR 2.0; 1.2-3.4). Of 162 patients with available DST result, 107 (66%) had multidrug-resistant tuberculosis (MDR-TB) and 32 (20%) had either pre-extensively drug resistant (pre-XDR) or extensively drug resistant tuberculosis (XDR-TB). We estimated that with the current algorithm 41% of pre-XDR or XDR-TB patients are diagnosed, and 33% of them started on an appropriate treatment regimen.
conclusionsMany patients with Xpert-diagnosed RR-TB either do not start MDR-TB treatment or encountered diagnostic and treatment delays under programmatic conditions in Indonesia, and most pre-XDR and XDR-TB cases remain undiagnosed. Further expansion and ongoing quality improvement of RR-TB services are urgently needed.
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