@article{PAR00016038,
  title = {{E}ffect of previous treatment and sputum quality on diagnostic accuracy of {X}pert(({R})) {MTB}/{RIF}},
  author = {{A}cuna-{V}illaorduna, {C}. and {O}rikiriza, {R}. and {N}yehangane, {D}. and {W}hite, {L}. {F}. and {M}wanga-{A}rnumpaire, {J}. and {K}im, {S}. and {B}onnet, {M}aryline and {F}ennelly, {K}. {P}. and {B}oum, {Y}. and {J}ones-{L}opez, {E}. {C}.},
  editor = {},
  language = {{ENG}},
  abstract = {{SETTING}: {I}n early studies, {X}pert(({R})) {MTB}/{RIF} accurately detected culture-proven pulmonary tuberculosis ({TB}). {R}ecent reports have, however, found a lower than expected specificity in previously treated {TB} patients. {OBJECTIVE}: {T}o investigate the diagnostic accuracy of {X}pert in presumptive pulmonary {TB} patients in {S}outhwestern {U}ganda. {DESIGN}: {W}e obtained demographic and clinical information and collected three sputum samples from each patient for smear microscopy, {X}pert and culture. {W}e estimated {X}pert sensitivity and specificity against culture, and stratified the analysis by previous treatment and sputum quality status. {RESULTS}: {W}e analyzed results from 860 presumptive {TB} patients, including 109 (13%) with a previous history of anti-tuberculosis treatment; 205 (24%) were culture-positive. {X}pert specificity was lower (91.8%, 95%{CI} 84.9-96.2) in previously treated than in new {TB} patients (97.5%, 95%{CI} 96.1-98.5; {P} = 0. 0 1). {I}n an adjusted analysis, patients with culture-,{X}pert+results were more likely to have been previously treated for {TB} ({OR} 8.3, 95%{CI} 2.1-32.0; {P} = 0.002), and to have mucosalivary sputum ({OR} 4.1, 95%{CI} 1.1-14.6; {P} = 0.03), but were less likely to self-report fever ({OR} 0.23, 95%{CI} 0.1-0.7; {P} = 0.008) than patients with concordant positive results. {CONCLUSION}: {X}pert specificity was lower in previously treated patients with suspected {TB}. {T}he clinical and programmatic impact of culture-, {X}pert+results requires evaluation in future studies.},
  keywords = {tuberculosis ; {X}pert(({R})) {MTB}/{RIF} ; specificity ; previous treatment ; sputum quality},
  booktitle = {},
  journal = {{I}nternational {J}ournal of {T}uberculosis and {L}ung {D}isease},
  volume = {21},
  numero = {4},
  pages = {389--397},
  ISSN = {1027-3719},
  year = {2017},
  DOI = {10.5588/ijtld.16.0785},
  URL = {https://www.documentation.ird.fr/hor/{PAR}00016038},
}