Related Experiment Video
Updated: Jul 3, 2026
08:10
Diagnosing Pulmonary Tuberculosis with the Xpert MTB/RIF Test
Published on: April 9, 2012
81.8K
Community-based "X-ray+Xpert® MTB/RIF ultra pooling test" case-finding strategy among high-risk groups in rural
Zhengwei Liu1, Ruiqi Chen1, Bing Li2
1Department of Tuberculosis Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, People's Republic of China.
Emerging Microbes & Infections
|January 12, 2026
Summary
This study introduces a cost-effective tuberculosis (TB) screening method using pooled Xpert® MTB/RIF Ultra testing for rural elderly populations. The integrated approach significantly improves active case-finding efficiency and reduces costs compared to traditional methods.
Area of Science:
- Public Health
- Infectious Disease Epidemiology
- Molecular Diagnostics
Background:
- Tuberculosis (TB) remains a significant public health challenge, particularly in high-incidence rural areas.
- Effective active case-finding (ACF) strategies are crucial but often face cost and logistical barriers.
- Screening elderly populations is vital due to their increased susceptibility to TB.
Purpose of the Study:
- To evaluate a novel community-based ACF strategy integrating pooled sputum molecular testing for TB detection.
- To assess the cost-effectiveness and yield of this integrated strategy in a high-incidence rural setting.
- To determine the feasibility of using pooled Xpert® MTB/RIF Ultra testing within routine health check-ups for TB screening.
Main Methods:
- A prospective study was conducted in rural Zhejiang, China, involving residents aged ≥65 years undergoing health check-ups.
- Chest X-rays (CXR) were used to identify participants with potential abnormalities.
- Sputum samples from eight individuals with abnormal CXR findings were pooled for Xpert® MTB/RIF Ultra testing, with positive pools undergoing individual retesting.
Main Results:
- The pooled testing strategy identified 32 bacteriologically confirmed TB cases among 1,883 participants with CXR abnormalities, achieving a 1.7% detection rate.
- The number needed to screen (NNS) was 218, significantly lower than chest X-ray-based alone ACF.
- The strategy reduced per-case screening costs to US$4.37 and per-confirmed-case cost to US$949.49.
Conclusions:
- Integrating pooled Xpert® MTB/RIF Ultra testing with routine health check-ups is a high-yield, cost-effective ACF strategy for active TB detection.
- This approach effectively targets high-risk elderly populations in rural settings, overcoming barriers to scalable community-based screening.
- The novel strategy offers a promising solution for improving TB control in resource-limited rural areas.
