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Xpert® MTB/RIF associated with improved treatment initiation among patients with smear-negative tuberculosis.
Zawedde-Muyanja, S; Manabe, Y C; Sewankambo, N K; Nakiyingi, L; Nakanjako, D.
Afiliação
  • Zawedde-Muyanja S; The Infectious Diseases Institute.
  • Manabe YC; The Infectious Diseases Institute, Department of Medicine, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda, Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
  • Sewankambo NK; Department of Medicine, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.
  • Nakiyingi L; The Infectious Diseases Institute, Department of Medicine, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.
  • Nakanjako D; The Infectious Diseases Institute, Department of Medicine, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.
Int J Tuberc Lung Dis ; 22(12): 1475-1480, 2018 12 01.
Article em En | MEDLINE | ID: mdl-30606320
BACKGROUND: Delayed diagnosis and treatment initiation of smear-negative tuberculosis (TB) patients can lead to increased morbidity and mortality, particularly among those co-infected with the human immunodeficiency virus (HIV). OBJECTIVE: To compare TB treatment initiation among smear-negative presumptive TB patients in the 6 months before and after the introduction of Xpert® MTB/RIF testing at five rural tertiary hospitals in Uganda. METHODS: Patient records of the dates and results of sputum analysis were extracted from TB laboratory registers and linked to those on treatment initiation as indicated in the TB treatment registers. The proportion of smear-negative presumptive patients who initiated anti-tuberculosis treatment was compared before and after Xpert implementation using χ² tests. Time to treatment was analysed using Kaplan-Meier survival analysis. RESULTS: Records from 3658 patients were analysed, 1894 before and 1764 after the introduction of Xpert testing. After the introduction of Xpert, 25% (437/1764) of smear-negative presumptive TB patients underwent testing. The proportion initiated on anti-tuberculosis treatment increased from 5.9% (112/1894) to 10.8% (190/1764) (P < 0.01). However, 37% (32/87) of patients with a confirmed TB diagnosis did not initiate treatment. Time to TB treatment initiation improved from 8 to 3.5 days between the study periods. CONCLUSION: Xpert testing was associated with improved TB treatment initiation among smear-negative presumptive TB patients. Improved utilisation and linkage to treatment could improve the impact of this test on patient-centred outcomes.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Rifampina / Infecções por HIV / Tuberculose Resistente a Múltiplos Medicamentos / Técnicas de Diagnóstico Molecular / Antibióticos Antituberculose Tipo de estudo: Diagnostic_studies / Risk_factors_studies Limite: Adolescent / Adult / Female / Humans / Male / Middle aged País/Região como assunto: Africa Idioma: En Ano de publicação: 2018 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Rifampina / Infecções por HIV / Tuberculose Resistente a Múltiplos Medicamentos / Técnicas de Diagnóstico Molecular / Antibióticos Antituberculose Tipo de estudo: Diagnostic_studies / Risk_factors_studies Limite: Adolescent / Adult / Female / Humans / Male / Middle aged País/Região como assunto: Africa Idioma: En Ano de publicação: 2018 Tipo de documento: Article