Publications

Detailed Information

The Feasibility, Accuracy, and Impact of Xpert MTB/RIF Testing in a Remote Aboriginal Community in Canada

Cited 10 time in Web of Science Cited 10 time in Scopus
Authors

Alvarez, Gonzalo G.; Van Dyk, Deborah D.; Desjardins, Marc; Yasseen, Abdool S., III; Aaron, Shawn D.; Cameron, D. William; Obed, Natan; Baikie, Maureen; Pakhale, Smita; Denkinger, Claudia M.; Sohn, Hojoon; Pai, Madhukar

Issue Date
2015-09
Publisher
ELSEVIER SCIENCE BV
Citation
CHEST, Vol.148 No.3, pp.767-773
Abstract
BACKGROUND: Xpert MTB/RIF testing for Mycobacterium tuberculosis and rifampin resistance is being used extensively in countries with a high burden of TB. However, recent evidence suggests that it may not have the same accuracy or impact in high-income, low-burden TB countries. METHODS: A prospective, pragmatic study was done between March 2012 and March 2014 to determine the feasibility, accuracy, and impact on TB disease management provided by the Xpert test in a remote, medically underserved, predominantly Inuit population in Iqaluit, Nunavut, Canada. RESULTS: A total of 453 Xpert tests were run on sputum samples from 344 patients with suspected TB. Twenty-seven patients were identified as having active TB disease by culture. There were no cases of drug-resistant TB. Using culture as the gold standard, one Xpert test compared with one, two, or three sputum samples cultured per patient had a sensitivity of 85% (95% CI, 66%-95%) and a specificity of 99% (95% CI, 97%-100%) for detection of M tuberculosis. The indeterminate rate was 4.4% of all samples run. Treatment initiation was significantly shortened using Xpert vs the national standard of three smears (1.8 days vs 7.7 days, P < .007) and particularly shorter in smear-negative, culture-positive cases (1.8 days vs 37.1 days, P < .008). CONCLUSIONS: In a predominantly Inuit population in a remote region of Canada where the burden of TB is high and no TB testing facilities are available, onsite Xpert testing was feasible and accurate and shortened the time to TB treatment initiation.
ISSN
0012-3692
URI
https://hdl.handle.net/10371/201767
DOI
https://doi.org/10.1378/chest.14-2948
Files in This Item:
There are no files associated with this item.
Appears in Collections:

Related Researcher

  • College of Medicine
  • Department of Human Systems Medicine
Research Area 결핵, 국제보건, 에이즈

Altmetrics

Item View & Download Count

  • mendeley

Items in S-Space are protected by copyright, with all rights reserved, unless otherwise indicated.

Share