Evaluation of Automated Molecular Testing Rollout for Tuberculosis Diagnosis Using Routinely Collected Surveillance Data — Uganda, 2012–2015

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dc.contributor.authorScott, Colleen
dc.contributor.authorWalusimbi, Simon
dc.contributor.authorKirenga, Bruce
dc.contributor.authorJoloba, Moses
dc.contributor.authorWinters, Muttamba
dc.contributor.authorNyombi, Abdunoor
dc.contributor.authorOdeke, Rosemary
dc.contributor.authorMwangi, Christine
dc.contributor.authorBirabwa, Estella
dc.contributor.authorMugabe, Frank
dc.contributor.authorCavanaugh, J. Sean
dc.date.accessioned2023-03-02T16:12:32Z
dc.date.available2023-03-02T16:12:32Z
dc.date.issued2017
dc.description.abstractIn 2012, Uganda introduced the use of GeneXpert MTB/RIF (Cepheid, Sunnyvale CA), a sensitive, automated, real-time polymerase chain reaction–based platform for tuberculosis (TB) diagnosis, for programmatic use among children, adults with presumptive human immunodeficiency virus (HIV)-associated TB, and symptomatic persons at risk for rifampicin (RIF)-resistant TB. The effect of using the platform’s Xpert MTB/RIF assay on TB care and control was assessed using routinely collected programmatic data; in addition, a retrospective review of district quarterly summaries using abstracted TB register data from purposively selected facilities in the capital city of Kampala was conducted. Case notification rates were calculated and nonparametric statistical methods were used for analysis. No statistically significant differences were observed in case notification rates before and after the Xpert MTB/RIF assay became available, although four of 10 districts demonstrated a statistically significant difference in bacteriologically confirmed TB. Once the GeneXpert MTB/RIF platform is established and refined, a more comprehensive evaluation should be conducted. The Xpert MTB/RIF assay detects genetic sequences of Mycobacterium tuberculosis complex as well as mutations associated with resistance to RIF and provides results in 2 hours. The test is much more sensitive than the conventional diagnostic test (sputum smear microscopy), with a pooled sensitivity among persons living with HIV infection of 80% (1). The World Health Organization recommends use of the Xpert MTB/RIF assay as the initial diagnostic test in adults and children with presumptive HIV-associated TB or multidrug resistant TB (2). It is hoped that the use of a more sensitive diagnostic test will increase case detection and notification; however, an evaluation of the Xpert MTB/RIF assay in Nepal found that use of Xpert MTB/RIF testing was associated with an increase in the proportion of TB diagnoses that were bacteriologically confirmed, but had little impact on overall rate of diagnoses or patient care, which might be the case in locations where clinical diagnosis and empiric TB treatment are commonen_US
dc.identifier.citationScott, C., Walusimbi, S., Kirenga, B., Joloba, M., Winters, M., Abdunoor, N., ... & Cavanaugh, J. S. (2017). Evaluation of automated molecular testing rollout for tuberculosis diagnosis using routinely collected surveillance data—Uganda, 2012–2015. Morbidity and Mortality Weekly Report, 66(12), 339.https://doi.org/10.15585%2Fmmwr.mm6612a6en_US
dc.identifier.urihttps://nru.uncst.go.ug/handle/123456789/8054
dc.language.isoenen_US
dc.publisherMorbidity and Mortality Weekly Reporten_US
dc.subjectEvaluationen_US
dc.subjectAutomated Molecular Testingen_US
dc.subjectTuberculosis Diagnosisen_US
dc.titleEvaluation of Automated Molecular Testing Rollout for Tuberculosis Diagnosis Using Routinely Collected Surveillance Data — Uganda, 2012–2015en_US
dc.typeArticleen_US
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