ArticleEClinicalMedicine2024
Impact of a multicomponent strategy including decentralized molecular testing for tuberculosis on mortality: planned analysis of a cluster-randomized trial in Uganda.
Article in EClinicalMedicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.
What it found
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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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed, 1 synthesis or guideline pooled it.
- Impact of rapid nucleic acid amplification tests for tuberculosis on patient outcomes.The Cochrane database of systematic reviews · 2025Pooled it
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
20 authors.
Funding
Abstract
Background: Rapid diagnosis of tuberculosis (TB) is important for improving outcomes and reducing transmission. Previous studies assessing the impact of Xpert MTB/RIF (Xpert), a molecular assay that provides results within 2 h, on mortality have been inconclusive. In this planned analysis of a pragmatic cluster-randomized trial in Uganda, we assessed whether a multicomponent strategy, including decentralized Xpert testing, decreased mortality among adults evaluated for TB. Methods: Ten community health centers were randomized, using a computer-generated randomization sequence, to the XPEL-TB intervention (on-site Xpert testing plus implementation supports) and ten to routine TB care without any modifications (on-site smear microscopy and referral-based Xpert testing for selected patients). The trial included all adults ( Findings: Vital status was ascertained for 8413 of 9563 (88%) XPEL-TB trial participants who presented at the health centers from October 22, 2018 through February 29, 2020. The adjusted rate ratio (aRR) was 0.77 (95% CI: 0.47-1.28), comparing the intervention (145 deaths/3655 person-years) to routine care (154 deaths/3015 person-years). In sub-group analyses, point estimates for mortality were lower in the intervention arm among people without HIV (aRR = 0.50, 95% CI: 0.26-0.96) and among females (aRR = 0.64, 95% CI: 0.33-1.23). The mortality risk analysis yielded similar results. Interpretation: Consistent point estimates favoring the intervention in our trial and previous ones suggest that Xpert testing may have an impact on mortality at community health centers. However, the magnitude of effect is small, and statistically significant results are unlikely to be attained within a single trial. Future trials of novel TB diagnostics at community health centers should focus on more proximal outcomes including TB detection and treatment initiation. Funding: This work was supported by the National Heart, Lung, and Blood Institute of the US National Institutes of Health under award number R01HL130192.
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