Evidence map›Paper›PMID 31969997›Full record

ArticleTuberculosis research and treatment2020

Chest Radiography and Xpert MTB/RIF® Testing in Persons with Presumptive Pulmonary TB: Gaps and Challenges from a District in Karnataka, India.

Manjula Kanakaraju, Sharath Burugina Nagaraja, Srinath Satyanarayana, Yella Ramesh Babu, Akshaya Kibballi Madhukeshwar, Somashekar Narasimhaiah

Open access · hybridAbstract read
In one paragraph

Article in Tuberculosis research and treatment, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
0.1field-weighted citation impact, top 50% 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

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 5 citations in OpenAlex.

  1. Pooled it
  2. Review
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

6 authors at 4 institutions in 1 country.

Manjula KanakarajuTaluka Health Office, Chikkaballapur, Karnataka, India.ORCID https://orcid.org/0000-0002-8449-3142
Sharath Burugina NagarajaESIC Medical College and PGIMSR, Bengaluru, Karnataka, India.ORCID https://orcid.org/0000-0002-6599-5753
Srinath SatyanarayanaCenter for Operational Research, International Union against Tuberculosis and Lung Disease, New Delhi, India.
Yella Ramesh BabuDistrict Tuberculosis Office, Chikkaballapur, Karnataka, India.
Akshaya Kibballi MadhukeshwarDepartment of Community Medicine, Yenepoya Medical College, Yenepoya (Deemed to be University), Mangaluru, Karnataka, India.
Somashekar NarasimhaiahNational Tuberculosis Institute, Bengaluru, Karnataka, India.
National Tuberculosis Institute · INESI - Post Graduate Institute of Medical Science and Research · INKarnataka Health Promotion Trust · INYenepoya University · IN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn India, as per the latest diagnostic algorithm, all persons with presumptive pulmonary TB (PPTB) are required to undergo sputum smear examination and chest radiography (CXR) upfront. Those with sputum smear positive, sputum smear negative, but CXR lesions suggestive of TB or those with strong clinical suspicion of TB are expected to undergo Xpert MTB/RIF® assay test (also known as CB-NAAT (cartridge-based nucleic acid amplification test)).

objectiveTo assess what proportion of PPTB who are undergoing sputum smear examination at microscopy centers of public health facilities have undergone CXR and CB-NAAT. To explore the barriers for uptake of CXR and CB-NAAT from the public health care provider's perspective.

methodsWe conducted a sequential explanatory mixed-methods study in Chikkaballapur district of Karnataka State, South India. The quantitative component involved a review of records of PPTB who had undergone sputum smear examination in a representative sample of seven microscopy centers. The qualitative component involved key informant interviews with four medical officers and group interviews with 9 paramedical staff.

resultsIn February and March 2019, about 732 PPTB had undergone smear examination. Of these, 301 (41%) had undergone CXR and 49 (7%) had undergone CB-NAAT. The proportion of PPTB who had undergone CXR varied across the seven microscopy centers (0% to 89%). CB-NAAT was higher in PPTB from urban areas when compared to rural areas (8% vs. 3%) and in those who were smear positive when compared to smear negative (65% vs. 2%). The major barriers for CXR and CB-NAAT were nonavailability of these tests at all microscopy centers and patients' reluctance to travel to the facilities where CXR and CB-NAAT services are available.

conclusionsCXR and CB-NAAT of PPTB are suboptimal. RNTCP should undertake measures to address these gaps in implementing its latest diagnostic algorithm.

Identifiers

PMID31969997
PMCPMC6969998
OpenAlexW2997904596

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LicenceCC BY
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Registered trials

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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.