Evidence map›Paper›PMID 37083706›Full record

ArticlePloS one2023

Diagnostic accuracy of Xpert MTB/RIF Ultra and culture assays to detect Mycobacterium Tuberculosis using OMNIgene-sputum processed stool among adult TB presumptive patients in Uganda.

Abdulwahab Sessolo, Emmanuel Musisi, Sylvia Kaswabuli, Josephine Zawedde, Patrick Byanyima, Wilber Sabiiti, Stanley Walimbwa, Joseph Ola, Ingvar Sanyu, Rejani Lalitha and 4 more

Open access · goldAbstract read
In one paragraph

Article in PloS one, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 2 pooled it
1.2field-weighted citation impact, top 23% 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

6 citing papers in PubMed, 2 syntheses or guidelines pooled it, 6 citations in OpenAlex.

  1. Pooled it
  2. Diagnostic accuracy of Xpert MTB/RIF Ultra for detecting pulmonary tuberculosis and rifampicin resistance: a systematic review and meta-analysis.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2025
    Pooled it
  3. Article
  4. Observational
  5. Review
  6. 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

14 authors at 6 institutions in 3 countries.

Abdulwahab SessoloInfectious Diseases Research Collaboration, Kampala, Uganda.ORCID 0000-0003-1793-5251
Emmanuel MusisiInfectious Diseases Research Collaboration, Kampala, Uganda.
Sylvia KaswabuliInfectious Diseases Research Collaboration, Kampala, Uganda.
Josephine ZaweddeInfectious Diseases Research Collaboration, Kampala, Uganda.
Patrick ByanyimaInfectious Diseases Research Collaboration, Kampala, Uganda.
Wilber SabiitiDivision of Infection and Global Health, School of Medicine, University of St. Andrews, Scotland, United Kingdom.ORCID 0000-0002-4742-2791
Stanley WalimbwaChina Uganda Friendship Hospital Naguru, Kampala, Uganda.
Joseph OlaChina Uganda Friendship Hospital Naguru, Kampala, Uganda.
Ingvar SanyuInfectious Diseases Research Collaboration, Kampala, Uganda.
Rejani LalithaDepartment of Internal Medicine, Makerere University College of Health Sciences, Kampala, Uganda.ORCID 0000-0003-0073-9879
Moses KamyaInfectious Diseases Research Collaboration, Kampala, Uganda.
Lucian DavisDepartment of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, United States of America.ORCID 0000-0002-8629-9992
William WorodriaInfectious Diseases Research Collaboration, Kampala, Uganda.
Laurence HuangInfectious Diseases Research Collaboration, Kampala, Uganda.
Infectious Diseases Research Collaboration · UGNaguru General Hospital · UGUniversity of St Andrews · GBMakerere University · UGUniversity of California, San Francisco · USYale University · US

Funding

Inflammation, Aging, Microbes, Obstructive Lung Disease and Diffusion Abnormalities (I AM OLD-DA) Study - Diversity SupplementR01HL128156 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI HUANG, LAURENCE, HUNT, PETER W · 2015 to 2024
$7.1M
NHLBI NIH HHS R01 HL128156
6 · The paper itself

Abstract

backgroundStool is a potential sample for diagnosing Mycobacterium tuberculosis (Mtb) in patients with difficulty in expectorating. However, high mycobacterial culture contamination rates and Xpert MTB/RIF Ultra test error rates on stool samples have limited its use. OMNIgene SPUTUM (OM-S) is a sample transport reagent with characteristics of sputum decontamination while maintaining viable Mtb. We evaluated the impact of OM-S on Mtb diagnostic yield from stool using smear microscopy, Xpert MTB/RIF Ultra, and culture among presumptive TB patients.

methodsPaired stool and expectorated sputum samples were collected from consecutive Ugandan adults undergoing diagnostic evaluation for pulmonary TB between June 2018 and June 2019. Stool was divided into 2 portions: one was homogenized in OM-S (OM-S stool) and the other in PBS (PBS stool) as control. Both sputum and processed stool were tested for Mtb using concentrated smear fluorescence microscopy (CFM), Xpert MTB/RIF Ultra (Xpert) and Mycobacteria Growth Indicator Tube (MGIT) culture. Sensitivity, specificity, and predictive values for each test were calculated against sputum MGIT culture as the reference standard.

resultsOf the 200 participants, 120 (60%) were male, 73 (37%) were HIV positive (median CD4 120 cells/uL (IQR 43-297)) and 128 (64%) had confirmed pulmonary TB by sputum MGIT culture. Seven (4%) OM-S stool Xpert samples reported errors while 47 (25%) and 103 (61%) were contaminated on OM-S stool MGIT and PBS stool MGIT, respectively. OM-S stool MGIT was able to accurately diagnose 56 of the contaminated PBS stool MGIT samples compared to only 5 of the contaminated OM-S stool MGIT samples diagnosed by PBS stool MGIT. Sensitivity (95% Confidence Interval, CI) 89% (83-94) for OM-S stool Xpert was higher compared to that of OM-S stool MGIT 60% (51-69) and PBS stool MGIT 42% (32-52). Specificity (95%CI) 91% (82-97) was also higher for OM-S stool Xpert compared to OM-S stool MGIT 64% (51-75) and PBS stool MGIT 26% (16-38).

conclusionStool processed with OM-S showed potential to improve Mtb diagnostic yield and reduce rates of indeterminate results when tested on Xpert and MGIT culture. The method may thus be of value in Mtb detection among patients with difficulty to expectorate.

Indexed as

Mycobacterium tuberculosisTuberculosis, PulmonaryAdultFemaleHumansMaleMicroscopy, FluorescenceSensitivity and SpecificitySputumUganda

Identifiers

PMID37083706
PMCPMC10121033
OpenAlexW4366602926

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.