1. A comparison of digital chest radiography and Xpert ® MTB/RIF in active case finding for tuberculosis.
- Author
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Nguyen TBP, Nguyen TA, Luu BK, Le TTO, Nguyen VS, Nguyen KC, Duong KD, Nguyen HB, Nguyen NL, Fox GJ, Nguyen NV, and Marks GB
- Subjects
- Adolescent, Female, Humans, Male, Middle Aged, Radiographic Image Enhancement, Radiography, Sensitivity and Specificity, Sputum, Vietnam, Mycobacterium tuberculosis, Tuberculosis, Tuberculosis, Pulmonary diagnostic imaging
- Abstract
OBJECTIVE: To compare two community screening tests for TB: sputum examination using Xpert
® MTB/RIF and chest radiography (CXR). METHOD: Men aged ≥15 years and women aged >45 years living in 96 sub-communes in Ca Mau, Viet Nam, were invited to provide a single sputum specimen that was tested using Xpert. Participants were also invited to attend a nearby location for digital radiography. Participants whose sputum was Xpert MTB-positive or whose CXR was reported as 'consistent with TB´ were requested to provide two further sputum specimens for culture. The sensitivities of the two tests for detecting TB (defined as sputum culture-positive for Mycobacterium tuberculosis ) were compared. RESULTS: There were 72 985 eligible participants, of whom 57 597 (78.9%) participated in Xpert screening, 12 752 (17.5%) had CXR and 11 235 (15.4%) had both tests. We estimated that there were 59 cases of TB, of whom 20 were Xpert MTB-positive (programmatic sensitivity 34.0%) and 47 had CXR reported as 'consistent with TB´ (sensitivity 80.0%, P < 0.0001). CONCLUSION: In community-wide screening for TB, CXR is more sensitive than a single spontaneously expectorated sputum sample tested using Xpert, but it has a substantially lower participation rate.- Published
- 2020
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