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DC Field | Value | Language |
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dc.contributor.author | Omondi, Alfred | - |
dc.date.accessioned | 2020-08-05T06:57:10Z | - |
dc.date.available | 2020-08-05T06:57:10Z | - |
dc.date.issued | 2017 | - |
dc.identifier.uri | http://ir.mu.ac.ke:8080/jspui/handle/123456789/3311 | - |
dc.description.abstract | Objective Xpert MTB/RIF is recommended by the World Health Organization (WHO) as the initial tuberculosis (TB) diagnostic test in individuals suspected of HIV-associated TB. We sought to evaluate field implementation of Xpert among a cohort of HIV/TB co-infected individuals, including availability, utilization and outcomes. Design Observational cohort study (patient-level data) and cross-sectional study (site-level Xpert availability data). Methods Data were collected at 30 participating International epidemiologic Databases to Evaluate AIDS (IeDEA) sites in 18 countries from January 2012-January 2016. All patients were HIV-infected and diagnosed with TB, either bacteriologically or clinically, and followed until a determination of TB treatment outcome. We used multivariable modified Poisson regression to estimate adjusted relative risk (RR) and 95% confidence intervals for unfavorable TB treatment outcomes. Results Most sites (63%) had access to Xpert, either in the clinic (13%), in the same facility (20%) or offsite (30%). Among 2722 HIV/TB patients included, median age was 35.4 years and 41% were female; BMI and CD4 count were low. Overall, most patients (76%) received at least one TB test; 45% were positive. Only 4% of all patients were tested using Xpert: 64% were Xpert-positive, 13% showed rifampicin (RIF) resistance and 30% were extrapulmonary (EPTB) or both pulmonary-EPTB. Treatment outcomes were mostly favorable (77%) and we found little association between Xpert use and an unfavorable TB treatment outcome (RR 1.25, 95%CI: 0.83, 1.90). Conclusions In this cohort, Xpert utilization was low even though the majority of sites had access to the test. Our findings show the need for exp | en_US |
dc.language.iso | en | en_US |
dc.publisher | PLOS | en_US |
dc.subject | HIV | en_US |
dc.title | Low implementation of Xpert MTB/RIF among HIV/TB co-infected adults in the International epidemiologic Databases to Evaluate AIDS (IeDEA) program | en_US |
dc.type | Article | en_US |
Appears in Collections: | School of Medicine |
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File | Description | Size | Format | |
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Low implementation of Xpert | 1.05 MB | Adobe PDF | View/Open |
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