The Diagnostic Performance of a Single GeneXpert MTB/RIF Assay in an Intensified Tuberculosis Case Finding Survey among HIV-Infected Prisoners in Malaysia
The Diagnostic Performance of a Single GeneXpert MTB/RIF Assay in an Intensified Tuberculosis Case Finding Survey among HIV-Infected Prisoners in Malaysia
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DOI：
10.1371/journal.pone.0073717
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发表时间：
2013-09-09
期刊：
影响因子：
3.7
通讯作者：
Kamarulzaman, Adeeba
中科院分区：
文献类型：
--
作者：
Al-Darraji, Haider Abdulrazzaq Abed;Abd Razak, Humaira;Kamarulzaman, Adeeba
背景：结核病（TB）诊断的延误，特别是在监狱中，与有害后果有关。新的GeneXpert MTB/RIF检测（Xpert）提供了对活动性结核病的准确和快速诊断，但其在提高高传播聚集环境中的病例发现方面的表现尚未得到评估。我们在马来西亚艾滋病毒感染的囚犯中进行了强化病例调查，评估了单一Xpert分析的诊断准确性。方法：在同一地点，hiv感染囚犯提供两份清晨痰标本，使用荧光涂片显微镜、BACTEC MGIT 960液体培养和单个Xpert进行检查。相对于MGIT 960液体培养的金标准结果计算Xpert的敏感性、特异性、阴性和阳性预测值。相关的临床和人口统计数据被用来检查活动性结核病的相关因素。结果：数据完整的入组受试者（N=125）大多数为男性（90.4%），年龄
Background: Delays in tuberculosis (TB) diagnosis, particularly in prisons, is associated with detrimental outcomes. The new GeneXpert MTB/RIF assay (Xpert) offers accurate and rapid diagnosis of active TB, but its performance in improving case detection in high-transmission congregate settings has yet to be evaluated. We assessed the diagnostic accuracy of a single Xpert assay in an intensified case finding survey among HIV infected prisoners in Malaysia.Methods: HIV-infected prisoners at a single site provided two early-morning sputum specimens to be examined using fluorescence smear microscopy, BACTEC MGIT 960 liquid culture and a single Xpert. The sensitivity, specificity, negative and positive predictive values of Xpert were calculated relative to gold-standard results using MGIT 960 liquid culture. Relevant clinical and demographic data were used to examine correlates of active TB disease.Results: The majority of enrolled subjects with complete data (N=125) were men (90.4%), age