GeneXpert--a game-changer for tuberculosis control?
Stephen Lawn and colleagues [11] report in this issue of PLoS Medicine that a single MTB/RIF test detected less than half of the cases of smear-negative culture-positive TB in HIV-positive patients being screened for TB to check whether they could safely be provided with chemoprophylaxis. [...]a sin...
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| Veröffentlicht in: | PLoS medicine 2011-07, Vol.8 (7), p.e1001064-e1001064 |
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| description | Stephen Lawn and colleagues [11] report in this issue of PLoS Medicine that a single MTB/RIF test detected less than half of the cases of smear-negative culture-positive TB in HIV-positive patients being screened for TB to check whether they could safely be provided with chemoprophylaxis. [...]a single MTB/RIF assay may be insufficient for "ruling-out" TB, although a second test for each patient increased sensitivity to 62%. Furthermore, experiences with HIV viral load and CD4 cell counting tests have demonstrated that advocacy can convince donors to fund the rapid implementation of relatively expensive diagnostic technologies when needs and benefits are clear, and the MTB/RIF test may be such a test. [...]costliness may not prevent the roll-out of this test to the limited numbers of TB patients requiring drug resistance testing, but may severely restrict the availability of this assay for the much larger numbers of people needing testing for suspected TB. |
| doi_str_mv | 10.1371/journal.pmed.1001064 |
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[...]a single MTB/RIF assay may be insufficient for "ruling-out" TB, although a second test for each patient increased sensitivity to 62%. Furthermore, experiences with HIV viral load and CD4 cell counting tests have demonstrated that advocacy can convince donors to fund the rapid implementation of relatively expensive diagnostic technologies when needs and benefits are clear, and the MTB/RIF test may be such a test. 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[...]a single MTB/RIF assay may be insufficient for "ruling-out" TB, although a second test for each patient increased sensitivity to 62%. Furthermore, experiences with HIV viral load and CD4 cell counting tests have demonstrated that advocacy can convince donors to fund the rapid implementation of relatively expensive diagnostic technologies when needs and benefits are clear, and the MTB/RIF test may be such a test. [...]costliness may not prevent the roll-out of this test to the limited numbers of TB patients requiring drug resistance testing, but may severely restrict the availability of this assay for the much larger numbers of people needing testing for suspected TB.</description><subject>Antibiotics, Antitubercular - pharmacology</subject><subject>Control</subject><subject>Diagnosis</subject><subject>Diagnostic equipment (Medical)</subject><subject>Diagnostic Tests, Routine - instrumentation</subject><subject>Diagnostic Tests, Routine - methods</subject><subject>DNA, Bacterial - analysis</subject><subject>DNA, Bacterial - genetics</subject><subject>Drug resistance</subject><subject>Drug resistance in microorganisms</subject><subject>Drug Resistance, Bacterial - drug effects</subject><subject>HIV</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Laboratories</subject><subject>Medicine</subject><subject>Microscopy</subject><subject>Molecular Diagnostic Techniques - 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pharmacology</topic><topic>Control</topic><topic>Diagnosis</topic><topic>Diagnostic equipment (Medical)</topic><topic>Diagnostic Tests, Routine - instrumentation</topic><topic>Diagnostic Tests, Routine - methods</topic><topic>DNA, Bacterial - analysis</topic><topic>DNA, Bacterial - genetics</topic><topic>Drug resistance</topic><topic>Drug resistance in microorganisms</topic><topic>Drug Resistance, Bacterial - drug effects</topic><topic>HIV</topic><topic>Human immunodeficiency virus</topic><topic>Humans</topic><topic>Laboratories</topic><topic>Medicine</topic><topic>Microscopy</topic><topic>Molecular Diagnostic Techniques - methods</topic><topic>Mortality</topic><topic>Mycobacterium tuberculosis - classification</topic><topic>Mycobacterium tuberculosis - drug effects</topic><topic>Mycobacterium tuberculosis - genetics</topic><topic>Mycobacterium tuberculosis - isolation & purification</topic><topic>Nucleic Acid Amplification Techniques - methods</topic><topic>Point-of-Care Systems</topic><topic>Rifampin - pharmacology</topic><topic>Sensitivity and Specificity</topic><topic>Tuberculosis</topic><topic>Tuberculosis - diagnosis</topic><topic>Tuberculosis - microbiology</topic><topic>Tuberculosis, Multidrug-Resistant - complications</topic><topic>Tuberculosis, Multidrug-Resistant - diagnosis</topic><topic>Tuberculosis, Multidrug-Resistant - microbiology</topic><topic>Tuberculosis, Pulmonary - complications</topic><topic>Tuberculosis, Pulmonary - diagnosis</topic><topic>Tuberculosis, Pulmonary - microbiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Evans, Carlton A</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Opposing Viewpoints</collection><collection>Gale In Context: Canada</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><collection>PLoS Medicine</collection><jtitle>PLoS medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Evans, Carlton A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>GeneXpert--a game-changer for tuberculosis control?</atitle><jtitle>PLoS medicine</jtitle><addtitle>PLoS Med</addtitle><date>2011-07-01</date><risdate>2011</risdate><volume>8</volume><issue>7</issue><spage>e1001064</spage><epage>e1001064</epage><pages>e1001064-e1001064</pages><issn>1549-1676</issn><issn>1549-1277</issn><eissn>1549-1676</eissn><abstract>Stephen Lawn and colleagues [11] report in this issue of PLoS Medicine that a single MTB/RIF test detected less than half of the cases of smear-negative culture-positive TB in HIV-positive patients being screened for TB to check whether they could safely be provided with chemoprophylaxis. [...]a single MTB/RIF assay may be insufficient for "ruling-out" TB, although a second test for each patient increased sensitivity to 62%. Furthermore, experiences with HIV viral load and CD4 cell counting tests have demonstrated that advocacy can convince donors to fund the rapid implementation of relatively expensive diagnostic technologies when needs and benefits are clear, and the MTB/RIF test may be such a test. [...]costliness may not prevent the roll-out of this test to the limited numbers of TB patients requiring drug resistance testing, but may severely restrict the availability of this assay for the much larger numbers of people needing testing for suspected TB.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>21814497</pmid><doi>10.1371/journal.pmed.1001064</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Antibiotics, Antitubercular - pharmacology Control Diagnosis Diagnostic equipment (Medical) Diagnostic Tests, Routine - instrumentation Diagnostic Tests, Routine - methods DNA, Bacterial - analysis DNA, Bacterial - genetics Drug resistance Drug resistance in microorganisms Drug Resistance, Bacterial - drug effects HIV Human immunodeficiency virus Humans Laboratories Medicine Microscopy Molecular Diagnostic Techniques - methods Mortality Mycobacterium tuberculosis - classification Mycobacterium tuberculosis - drug effects Mycobacterium tuberculosis - genetics Mycobacterium tuberculosis - isolation & purification Nucleic Acid Amplification Techniques - methods Point-of-Care Systems Rifampin - pharmacology Sensitivity and Specificity Tuberculosis Tuberculosis - diagnosis Tuberculosis - microbiology Tuberculosis, Multidrug-Resistant - complications Tuberculosis, Multidrug-Resistant - diagnosis Tuberculosis, Multidrug-Resistant - microbiology Tuberculosis, Pulmonary - complications Tuberculosis, Pulmonary - diagnosis Tuberculosis, Pulmonary - microbiology |
| title | GeneXpert--a game-changer for tuberculosis control? |
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