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Free Content Chest X-ray vs. Xpert® MTB/RIF assay for the diagnosis of sputum smear-negative tuberculosis in Uganda

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SETTING: An out-patient clinic in a country with high rates of tuberculosis-human immunodeficiency virus (TB-HIV) co-infection.

DESIGN: Cross-sectional analytical study of 123 adults with chronic cough and no previous anti-tuberculosis treatment. Demographic, clinical, chest X-ray (CXR) and GeneXpert® MTB/RIF data were collected. Proportions of TB diagnoses using both tests were calculated and compared using an unpaired t-test.

RESULTS: Sixty-six patients (53.7%) were female and 35 (28.5%) tested positive for HIV; 21 (17.1%) were Xpert-positive, while 51 (42.5%) had CXR suggestive of TB (P = 0.0018), of whom only 15 (29.4%) were Xpert-positive. CXR was suggestive of pulmonary TB in 15 (71.4%) of the 21 patients with a positive Xpert test.

CONCLUSIONS: The majority of the sputum smear-negative patients did not have TB on single Xpert testing. CXR gave an overestimate of sputum smear-negative TB cases.
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Keywords: Xpert MTB/RIF; pulmonary tuberculosis; sputum smear-negative PTB

Document Type: Research Article

Affiliations: 1: Medical Research Council/Uganda Virus Research Institute, Uganda Research Unit on AIDS, Entebbe, Uganda 2: Department of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda 3: Department of Medical Microbiology, College of Health Sciences, Makerere University, Kampala, Uganda

Publication date: 2014-02-01

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

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