Results from early programmatic implementation of Xpert MTB/RIF testing in nine countries.
Results from early programmatic implementation of Xpert MTB/RIF testing in nine countries.
复制标题
DOI：
10.1186/1471-2334-14-2
复制
发表时间：
2014-01-02
影响因子：
3.7
通讯作者：
Ditiu L
中科院分区：
文献类型：
--
作者：
Creswell J;Codlin AJ;Andre E;Micek MA;Bedru A;Carter EJ;Yadav RP;Mosneaga A;Rai B;Banu S;Brouwer M;Blok L;Sahu S;Ditiu L
Xpert MTB/RIF检测试剂盒作为一种灵敏、快速的诊断工具，可提高敏感性和耐药性结核病的检出率，已引起了广泛关注。然而，大多数现有文献仅描述了MTB/RIF检测在研究条件下的性能;关于其在常规病例发现中使用的信息很少。结核病REACH是一项多国倡议，重点是改进病例通报的创新方法。我们选择了9个结核病REACH项目的便利样本，以涵盖一系列实施者、地区和方法。每个项目中MTB/RIF实施前12个月的标准季度报告和机器数据用于分析患者产量、利福平耐药性和失败测试。数据收集时间为2011年9月至2013年3月。对项目工作人员进行了问卷调查和半结构化访谈，以收集关于用户体验和挑战的信息。所有项目都对疑似结核病患者进行MTB/RIF检测，而不是对已确诊患者进行耐药性检测。这些项目将65台机器（196个模块）放置在各种设施中，并采用了许多病例发现策略和测试算法。这些项目进行了47，973次MTB/RIF测试。在有效检测中，7，195例（16.8%）为MTB阳性。共发现982例利福平耐药结果（占阳性检测的13.6%）。在所有测试中，10.6%失败。所有项目都注意到需要持续供电，大多数采用当地采购的解决办法。在报告和记录成果的方式方面存在很大差异，反映出一些国家缺乏标准化指导。本研究的结果开始填补了MTB/RIF检测的指南、研究结果和实际实施之间的空白。Xpert MTB/RIF检测发现了大量常规服务未能检测到的结核病患者。该研究展示了该技术的多功能性和影响，但也概述了各种可克服的实施障碍。该研究并不代表所有早期实施者在MTB/RIF测试方面的经验，而是概述了共同的问题以及许多不同的MTB/RIF方案实施方法。
The Xpert MTB/RIF assay has garnered significant interest as a sensitive and rapid diagnostic tool to improve detection of sensitive and drug resistant tuberculosis. However, most existing literature has described the performance of MTB/RIF testing only in study conditions; little information is available on its use in routine case finding. TB REACH is a multi-country initiative focusing on innovative ways to improve case notification. We selected a convenience sample of nine TB REACH projects for inclusion to cover a range of implementers, regions and approaches. Standard quarterly reports and machine data from the first 12 months of MTB/RIF implementation in each project were utilized to analyze patient yields, rifampicin resistance, and failed tests. Data was collected from September 2011 to March 2013. A questionnaire was implemented and semi-structured interviews with project staff were conducted to gather information on user experiences and challenges. All projects used MTB/RIF testing for people with suspected TB, as opposed to testing for drug resistance among already diagnosed patients. The projects placed 65 machines (196 modules) in a variety of facilities and employed numerous case-finding strategies and testing algorithms. The projects consumed 47,973 MTB/RIF tests. Of valid tests, 7,195 (16.8%) were positive for MTB. A total of 982 rifampicin resistant results were found (13.6% of positive tests). Of all tests conducted, 10.6% failed. The need for continuous power supply was noted by all projects and most used locally procured solutions. There was considerable heterogeneity in how results were reported and recorded, reflecting the lack of standardized guidance in some countries. The findings of this study begin to fill the gaps among guidelines, research findings, and real-world implementation of MTB/RIF testing. Testing with Xpert MTB/RIF detected a large number of people with TB that routine services failed to detect. The study demonstrates the versatility and impact of the technology, but also outlines various surmountable barriers to implementation. The study is not representative of all early implementer experiences with MTB/RIF testing but rather provides an overview of the shared issues as well as the many different approaches to programmatic MTB/RIF implementation.
登录
查看更多内容
结核病诊断的进展：XPERT MTB/RIF分析和未来的预期测试。
DOI：
10.1016/s1473-3099(13)70008-2
发表时间：
2013-04
期刊：
The Lancet. Infectious diseases
影响因子：
--
作者：
Lawn SD;Mwaba P;Bates M;Piatek A;Alexander H;Marais BJ;Cuevas LE;McHugh TD;Zijenah L;Kapata N;Abubakar I;McNerney R;Hoelscher M;Memish ZA;Migliori GB;Kim P;Maeurer M;Schito M;Zumla A
通讯作者：
Zumla A
DOI：
10.1097/qai.0b013e318258c6af
发表时间：
2012-07-01
影响因子：
3.6
作者：
Lawn, Stephen D.;Kerkhoff, Andrew D.;Wood, Robin
通讯作者：
Wood, Robin
影响因子：
15.8
作者：
Vassall A;van Kampen S;Sohn H;Michael JS;John KR;den Boon S;Davis JL;Whitelaw A;Nicol MP;Gler MT;Khaliqov A;Zamudio C;Perkins MD;Boehme CC;Cobelens F
通讯作者：
Cobelens F
DOI：
10.1016/j.diagmicrobio.2012.06.013
发表时间：
2012-10-01
影响因子：
2.9
作者：
Williamson, Deborah A.;Basu, Indira;Roberts, Sally A.
通讯作者：
Roberts, Sally A.
影响因子：
9.4
作者：
Friedrich, Sven O.;von Groote-Bidlingmaier, Florian;Diacon, Andreas H.
通讯作者：
Diacon, Andreas H.