SynthesisEmerging infectious diseases2021
Systematic Review of Pooling Sputum as an Efficient Method for Xpert MTB/RIF Tuberculosis Testing during the COVID-19 Pandemic.
Synthesis in Emerging infectious diseases, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
25 citing papers in PubMed, 1 synthesis or guideline pooled it, 35 citations in OpenAlex.
- Diagnostic accuracy of GeneXpert in the diagnosis of spinal tuberculosis: A systematic review and meta-analysis.Narra J · 2024Pooled it
- Diagnostic Performance of the Pluslife MiniDock MTB and Molbio MTB Ultima Assays to Detect Tuberculosis From Tongue and Sputum Swabs Among Outpatients and in Active Case Finding in Cameroon.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Article
- Feasibility and acceptability of pooled sputum testing for tuberculosis: a multicountry qualitative study of the Start4All project.BMJ open · 2026Article
- A train-and-assist device that upskills novices to strengthen the workforce and expand diagnostic access.PNAS nexus · 2026Article
- Key operational challenges at a programmatic level to achieve optimal use of the GeneXpert platform.IJTLD open · 2026Article
- In-home molecular testing of tongue swabs and sputum to inform household-level screening with diagnostic escalation strategies for tuberculosis contact investigation: a prospective cohort study in South Africa.medRxiv : the preprint server for health sciences · 2026Article
- Tuberculosis in prisons: an integrated prevention and care cascade for a persistent structural epidemic.Frontiers in public health · 2026Review
- Using sputum and tongue swab specimens for in-home point-of-care targeted universal testing for tuberculosis of household contacts: an acceptability and feasibility analysis.BMJ global health · 2025Article
- Tuberculosis Diagnosis, Treatment, and Prevention Services for Children Living with HIV in Low- and Middle-Income Countries: A Multiregional Site Survey.Journal of the Pediatric Infectious Diseases Society · 2025Article
- Implementation of pooled testing to increase access to routine viral load monitoring for people living with HIV on antiretroviral therapy.Scientific reports · 2025Article
- Validation study of a novel, rapid, open platform real-time LAMP assay for early diagnosis of pulmonary tuberculosis.Scientific reports · 2025Article
- Sputum pooling for rapid and cost-effective active case-finding for TB in prisons.The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2025Article
- Assessing the impact of COVID-19 management on the workload of human resources working in India's National Tuberculosis Elimination Program.BMC health services research · 2024Article
- Finding the missed millions: innovations to bring tuberculosis diagnosis closer to key populations.BMC global and public health · 2024Review
- Clinical performance of AI-integrated risk assessment pooling reveals cost savings even at high prevalence of COVID-19.Scientific reports · 2024Article
- Expanding molecular diagnostic coverage for tuberculosis by combining computer-aided chest radiography and sputum specimen pooling: a modeling study from four high-burden countries.BMC global and public health · 2024Article
- The impact of sputum quality on Xpert positivity in active case-finding for TB.The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2024Article
- Comparing tuberculosis symptom screening to chest X-ray with artificial intelligence in an active case finding campaign in Northeast Nigeria.BMC global and public health · 2023Article
- Implementation of large-scale pooled testing to increase rapid molecular diagnostic test coverage for tuberculosis: a retrospective evaluation.Scientific reports · 2023Article
- Pooling sputum testing to diagnose tuberculosis using xpert MTB/RIF and xpert ultra: a cost-effectiveness analysis.BMC infectious diseases · 2023Article
Corrections and comments
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Authors and funding
13 authors at 5 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
GeneXpert-based testing with Xpert MTB/RIF or Ultra assays is essential for tuberculosis diagnosis. However, testing may be affected by cartridge and staff shortages. More efficient testing strategies could help, especially during the coronavirus disease pandemic. We searched the literature to systematically review whether GeneXpert-based testing of pooled sputum samples achieves sensitivity and specificity similar to testing individual samples; this method could potentially save time and preserve the limited supply of cartridges. From 6 publications, we found 2-sample pools using Xpert MTB/RIF had 87.5% and 96.0% sensitivity (average sensitivity 94%; 95% CI 89.0%-98.0%) (2 studies). Four-sample pools averaged 91% sensitivity with Xpert MTB/RIF (2 studies) and 98% with Ultra (2 studies); combining >4 samples resulted in lower sensitivity. Two studies reported that pooling achieved 99%-100% specificity and 27%-31% in cartridge savings. Our results show that pooling may improve efficiency of GeneXpert-based testing.
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Registered trials
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.