The diagnostic performance of a single GeneXpert MTB/RIF assay in an intensified tuberculosis case finding survey among HIV-infected prisoners in Malaysia

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 ev...

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Bibliographic Details
Published in:PloS one 2013-09, Vol.8 (9), p.e73717-e73717
Main Authors: Al-Darraji, Haider Abdulrazzaq Abed, Abd Razak, Humaira, Ng, Kee Peng, Altice, Frederick L, Kamarulzaman, Adeeba
Format: Article
Language:English
Subjects:
Acquired immune deficiency syndrome
Adult
AIDS
Antiretroviral agents
Antiretroviral therapy
Assaying
Bacteriological Techniques
CD4 antigen
Cell culture
Cell number
Demographics
Diagnosis
Diagnostic systems
Diagnostic Tests, Routine - methods
Disease transmission
Drug abuse
Drugs
Female
Fluorescence
Fluorescence microscopy
Highly active antiretroviral therapy
HIV
HIV infections
HIV Infections - complications
HIV patients
HIV tests
Human immunodeficiency virus
Humans
Liquid culture
Malaysia
Male
Medical diagnosis
Microscopy
Mortality
Multivariate Analysis
Mycobacterium tuberculosis
Mycobacterium tuberculosis - isolation & purification
Prisoners
Prisoners - statistics & numerical data
Prisons
Reproducibility of Results
Screening
Sensitivity
Sensitivity and Specificity
Smear
Sputum
Sputum - microbiology
Tuberculosis
Tuberculosis, Pulmonary - complications
Tuberculosis, Pulmonary - diagnosis
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Summary: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. 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. The majority of enrolled subjects with complete data (N=125) were men (90.4%), age
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0073717