| Title |
Evaluation of gene xpert for routine diagnosis of HIV-associated tuberculosis in Nigeria: A prospective cohort study
|
|---|---|
| Published in |
BMC Pulmonary Medicine, May 2017
|
| DOI | 10.1186/s12890-017-0430-6 |
| Pubmed ID | |
| Authors |
Maxwell Oluwole Akanbi, Chad Achenbach, Babafemi Taiwo, John Idoko, Agatha Ani, Yetunde Isa, Oche Agbaji, Christiana Ukoli, Patrick Akande, Mamoudou Maiga, Robert Leo Murphy |
| Abstract |
Xpert MTB/Rif (Xpert) is described as a game changer in tuberculosis (TB) control. We evaluated the impact of Xpert on diagnosis, time to treatment, and treatment outcome among patients with HIV associated TB in Nigeria. Adults with HIV being evaluated for pulmonary TB (PTB) were consecutively enrolled into the study cohort. At baseline, expectorated sputa were examined using Xpert and smear microscopy for Mycobacterium tuberculosis (MTB) and acid fast bacilli, respectively. Patients diagnosed with TB were followed-up until 6 months post TB diagnosis. TB was defined as sputum positive by smear microscopy, Xpert detection of MTB (bacteriologically confirmed case), or clinician diagnosed TB with initiation of full TB treatment (clinical diagnosis). Time to treatment was time from first clinic presentation for TB evaluation to initiation of TB treatment. We examined the proportion PTB patients with a positive Xpert result and compared time to TB treatment and outcome of TB treatment in patients based on sputum test results. A total of 310 adults with HIV were enrolled. The median CD4 cell count was 242 (interquartile range (IQR) 120-425) cells/mm(3) and 88.1% were receiving antiretroviral therapy (ART). PTB was diagnosed in 76 (24.5%) patients, with 71 (93.4%) being bacteriologically confirmed. Among patients with PTB, 56 (73.7%) were Xpert positive. Median time to treatment was 5 (IQR 2-8) days and 12 (IQR 5-35) days in patient with and without Xpert positive results, respectively; p = 0.005. Overall 73.1% had symptom free survival at 6 months post PTB treatment initiation with no significant differences observed based on TB test method. 10 (14.9%) died within 6 months of TB treatment initiation. In analysis adjusted for age, sex, and mode of diagnosis (Xpert positive or negative), only ART use independently predicted mortality (AOR 0.10; 95% CI 0.01-0.93). The use of Xpert for routine care reduced time to PTB treatment, but did not improve survival in patients with HIV treated for susceptible PTB. |
X Demographics
The data shown below were collected from the profiles of 2 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United Kingdom | 1 | 50% |
| Unknown | 1 | 50% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 2 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 110 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 110 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 26 | 24% |
| Researcher | 16 | 15% |
| Student > Ph. D. Student | 11 | 10% |
| Student > Bachelor | 10 | 9% |
| Student > Doctoral Student | 5 | 5% |
| Other | 13 | 12% |
| Unknown | 29 | 26% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 41 | 37% |
| Nursing and Health Professions | 9 | 8% |
| Agricultural and Biological Sciences | 7 | 6% |
| Immunology and Microbiology | 7 | 6% |
| Biochemistry, Genetics and Molecular Biology | 3 | 3% |
| Other | 9 | 8% |
| Unknown | 34 | 31% |
Attention Score in Context
This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 01 June 2017.
All research outputs
#15,157,864
of 23,313,051 outputs
Outputs from BMC Pulmonary Medicine
#1,015
of 1,974 outputs
Outputs of similar age
#189,252
of 316,951 outputs
Outputs of similar age from BMC Pulmonary Medicine
#21
of 35 outputs
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