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Evaluation of gene xpert for routine diagnosis of HIV-associated tuberculosis in Nigeria: A prospective cohort study

Overview of attention for article published in BMC Pulmonary Medicine, May 2017
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Title
Evaluation of gene xpert for routine diagnosis of HIV-associated tuberculosis in Nigeria: A prospective cohort study
Published in
BMC Pulmonary Medicine, May 2017
DOI 10.1186/s12890-017-0430-6
Pubmed ID
Authors

Maxwell Oluwole Akanbi, Chad Achenbach, Babafemi Taiwo, John Idoko, Agatha Ani, Yetunde Isa, Oche Agbaji, Christiana Ukoli, Patrick Akande, Mamoudou Maiga, Robert Leo Murphy

Abstract

Xpert MTB/Rif (Xpert) is described as a game changer in tuberculosis (TB) control. We evaluated the impact of Xpert on diagnosis, time to treatment, and treatment outcome among patients with HIV associated TB in Nigeria. Adults with HIV being evaluated for pulmonary TB (PTB) were consecutively enrolled into the study cohort. At baseline, expectorated sputa were examined using Xpert and smear microscopy for Mycobacterium tuberculosis (MTB) and acid fast bacilli, respectively. Patients diagnosed with TB were followed-up until 6 months post TB diagnosis. TB was defined as sputum positive by smear microscopy, Xpert detection of MTB (bacteriologically confirmed case), or clinician diagnosed TB with initiation of full TB treatment (clinical diagnosis). Time to treatment was time from first clinic presentation for TB evaluation to initiation of TB treatment. We examined the proportion PTB patients with a positive Xpert result and compared time to TB treatment and outcome of TB treatment in patients based on sputum test results. A total of 310 adults with HIV were enrolled. The median CD4 cell count was 242 (interquartile range (IQR) 120-425) cells/mm(3) and 88.1% were receiving antiretroviral therapy (ART). PTB was diagnosed in 76 (24.5%) patients, with 71 (93.4%) being bacteriologically confirmed. Among patients with PTB, 56 (73.7%) were Xpert positive. Median time to treatment was 5 (IQR 2-8) days and 12 (IQR 5-35) days in patient with and without Xpert positive results, respectively; p = 0.005. Overall 73.1% had symptom free survival at 6 months post PTB treatment initiation with no significant differences observed based on TB test method. 10 (14.9%) died within 6 months of TB treatment initiation. In analysis adjusted for age, sex, and mode of diagnosis (Xpert positive or negative), only ART use independently predicted mortality (AOR 0.10; 95% CI 0.01-0.93). The use of Xpert for routine care reduced time to PTB treatment, but did not improve survival in patients with HIV treated for susceptible PTB.

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Mendeley readers

The data shown below were compiled from readership statistics for 85 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 85 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 23 27%
Researcher 15 18%
Student > Ph. D. Student 10 12%
Student > Doctoral Student 5 6%
Student > Postgraduate 5 6%
Other 11 13%
Unknown 16 19%
Readers by discipline Count As %
Medicine and Dentistry 34 40%
Agricultural and Biological Sciences 7 8%
Nursing and Health Professions 7 8%
Immunology and Microbiology 6 7%
Biochemistry, Genetics and Molecular Biology 3 4%
Other 9 11%
Unknown 19 22%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 01 June 2017.
All research outputs
#12,639,619
of 15,916,110 outputs
Outputs from BMC Pulmonary Medicine
#905
of 1,302 outputs
Outputs of similar age
#198,541
of 272,657 outputs
Outputs of similar age from BMC Pulmonary Medicine
#1
of 1 outputs
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