ArticleBMJ global health2022
Pooled testing of sputum with Xpert MTB/RIF and Xpert Ultra during tuberculosis active case finding campaigns in Lao People's Democratic Republic.
Article in BMJ global health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 17 citations in OpenAlex.
- Community-based "X-ray+Xpert® MTB/RIF ultra pooling test" case-finding strategy among high-risk groups in rural areas: a prospective application study.Emerging microbes & infections · 2026Article
- Assessing the potential for specimen pooling to streamline nosocomial surveillance of methicillin-resistantMicrobiology spectrum · 2026Article
- Does nutritional support contribute to mitigating the financial burden faced by TB-affected households?IJTLD open · 2025Article
- Prevalence of Xpert MTB/RIF Ultra Trace Call Results and Associated Risk Factors During Active Tuberculosis Case Finding in Viet Nam: A Programmatic Evaluation.Diagnostics (Basel, Switzerland) · 2025Article
- Pooling sputum samples for the Xpert MTB/RIF assay: a practical screening strategy for highly infectious tuberculosis cases.BMC infectious diseases · 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
- 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
- Pooling sputum samples for Xpert® MTB/RIF and Xpert® Ultra testing for TB diagnosis.Public health action · 2023Article
- Dorfman pooling enhances SARS-CoV-2 large-scale community testing efficiency.PLOS global public health · 2023Article
Corrections and comments
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Authors and funding
13 authors at 4 institutions in 4 countries.
Funding
Abstract
introductionActive case finding (ACF) of individuals with tuberculosis (TB) is a key intervention to find the 30% of people missed every year. However, ACF requires screening large numbers of individuals who have a low probability of positive results, typically <5%, which makes using the recommended molecular tests expensive.
methodsWe conducted two ACF surveys (in 2020 and 2021) in high TB burden areas of Lao PDR. Participants were screened for TB symptoms and received a chest X-ray. Sputum samples of four consecutive individuals were pooled and tested with Xpert Mycobacterium tuberculosis (MTB)/rifampicin (RIF) (Xpert-MTB/RIF) (2020) or Xpert-Ultra (2021). The agreement of the individual and pooled samples was compared and the reasons for discrepant results and potential cartridge savings were assessed.
resultsEach survey included 436 participants, which were tested in 109 pools. In the Xpert-MTB/RIF survey, 25 (sensitivity 89%, 95% CI 72.8% to 96.3%) of 28 pools containing MTB-positive samples tested positive and 81 pools containing only MTB-negative samples tested negative (specificity 100%, 95% CI 95.5% to 100%). In the Xpert-Ultra survey, all 32 (sensitivity 100%, 95% CI 89.3% to 100%) pools containing MTB-positive samples tested positive and all 77 (specificity 100%, 95% CI 95.3% to 100%) containing only MTB-negative samples tested negative. Pooling with Xpert-MTB/RIF and Xpert-Ultra saved 52% and 46% (227/436 and 199/436, respectively) of cartridge costs alone.
conclusionTesting single and pooled specimens had a high level of agreement, with complete concordance when using Xpert-Ultra. Pooling samples could generate significant cartridge savings during ACF campaigns.
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