Low-cost diagnostic test for susceptible and drug-resistant tuberculosis in rural Malawi
Zhang, Annie (The Ohio State University. Department of Microbiology, College of Arts and Sciences)
Jumbe, Enoch (Child Legacy International, Msundwe, Lilongwe, Malawi)
Krysiak, Robert (University of North Carolina Project. Department of Infectious Diseases)
Sidiki, Sabeen (The Ohio State University. Department of Microbial Infection and Immunity)
Kelley, Holden V. (The Ohio State University. Department of Microbial Infection and Immunity)
Chemey, Elly K. (Child Legacy International, Msundwe, Lilongwe, Malawi)
Kamba, Chancy (District Tuberculosis Control Office, Ministry of Health, Lilongwe, Malawi)
Mwapasa, Victor (College of Medicine (Blantyre, Malawi). Department of Community Health)
García, Juan Ignacio (Universitat Autònoma de Barcelona. Departament de Pediatria, Obstetrícia i Ginecologia i Medicina Preventiva i Salut Pública)
Norris, Alison (The Ohio State University. College of Public Health)
Pan, Xueliang J. (The Ohio State University. Center for Biostatistics)
Evans, Carlton (Unversidad Cayetano Heredia (Lima, Perú). Department of Microbiology)
Wang, Shu-Hua (The Ohio State University. Division of Infectious Diseases)
Kwiek, Jesse J. (The Ohio State University. Department of Microbiology)
Torrelles, Jordi B. (The Ohio State University. Department of Microbial Infection and Immunity)

Fecha:	2018
Resumen:	Rural settings where molecular tuberculosis diagnostics are not currently available need easy-to-use tests that do not require additional processing or equipment. While acid-fast bacilli (AFB) smear is the most common and often only tuberculosis diagnosis test performed in rural settings, it is labour intensive, has less-than-ideal sensitivity, and cannot assess tuberculosis drug susceptibility patterns. The objective of this study was to determine the feasibility of a multidrug-resistant (MDR) or extensively drug-resistant (XDR)-tuberculosis coloured agar-based culture test (tuberculosis CX-test), which can detect Mycobacterium tuberculosis growth and evaluate for drug susceptibility to isoniazid, rifampicin and a fluoroquinolone (i. e. ciprofloxacin) in approximately 14 days. In this study, 101 participants were enrolled who presented to a rural health clinic in central Malawi. They were suspected of having active pulmonary tuberculosis. Participants provided demographic and clinical data and submitted sputum samples for tuberculosis testing using the AFB smear and tuberculosis CX-test. The results showed a high level of concordance between the AFB smear (12 positive) and tuberculosis CX-test (13 positive); only one sample presented discordant results, with the molecular GeneXpert MTB/RIF ® test confirming the tuberculosis CX-test results. The average time to a positive tuberculosis CX-test was 10 days. Of the positive samples, the tuberculosis CX-test detected no cases of drug resistance, which was later confirmed by the GeneXpert MTB/RIF ®. These findings demonstrate that the tuberculosis CX-test could be a reliable low-cost diagnostic method for active pulmonary tuberculosis in high tuberculosis burden rural areas.
Nota:	Altres ajuts: This study was partially funded by The Ohio State University Public Health Preparedness for Infectious Diseases Program (OSU-PHPID), OSU Office of International Affairs, and OSU College of Medicine funds to J.J.K. and J.B.T.
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Publicado en:	African Journal of Laboratory Medicine, Vol. 7 (june 2018) , ISSN 2225-2010

DOI: 10.4102/ajlm.v7i1.690
PMID: 29977794

6 p, 2.2 MB

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