1. Diagnostic performance of the Abbott RealTime MTB assay for tuberculosis diagnosis in people living with HIV.
- Author
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Saavedra B, Mambuque E, Gomes N, Nguenha D, Mabunda R, Faife L, Langa R, Munguambe S, Manjate F, Cossa A, Scott L, and García-Basteiro AL
- Subjects
- Adult, DNA, Bacterial genetics, DNA, Bacterial isolation & purification, Drug Resistance, Bacterial genetics, Female, HIV Infections immunology, Humans, Isoniazid pharmacology, Isoniazid therapeutic use, Male, Mozambique, Mycobacterium tuberculosis genetics, Prospective Studies, Real-Time Polymerase Chain Reaction instrumentation, Rifampin pharmacology, Rifampin therapeutic use, Sensitivity and Specificity, Tuberculosis drug therapy, Tuberculosis immunology, Tuberculosis microbiology, Young Adult, HIV Infections complications, Mycobacterium tuberculosis isolation & purification, Reagent Kits, Diagnostic, Tuberculosis diagnosis
- Abstract
Strengthening tuberculosis diagnosis is an international priority and the advocacy for multi-disease testing devices raises the possibility of improving laboratory efficiency. However, the advantages of centralized platforms might not translate into real improvements under operational conditions. This study aimed to evaluate the field use of the Abbott RealTime MTB (RT-MTB) and Xpert MTB/RIF assays, in a large cohort of HIV-positive and TB presumptive cases in Southern Mozambique. Over a 6-month period, 255 HIV-positive TB presumptive cases were consecutively recruited in the high TB/HIV burden district of Manhiça. The diagnostic performance of both assays was evaluated against two different reference standards: a microbiological gold standard (MGS) and a composite reference standard (CRS). Results from the primary analysis (MGS) showed improved sensitivity (Se) and reduced specificity (Sp) for the Abbott RT-MTB assay compared to the Xpert MTB/RIF (RT-MTB Se: 0.92 (95% CI: 0.75;0.99) vs Xpert Se: 0.73 (95% CI: 0.52;0.88) p value = 0.06; RT-MTB Sp: 0.80 (0.72;0.86) vs Xpert Sp: 0.96 (0.92;0.99) p value < 0.001). The lower specificity may be due to cross-reactivity with non-tuberculous mycobacteria (NTMs), the detection of non-viable MTBC, or the identification of true TB cases missed by the gold standard., (© 2021. The Author(s).)
- Published
- 2021
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