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实施大规模的聚合测试,以增加结核病快速分子诊断测试的覆盖范围:一个回顾性评估

Comfort Vuchas¹, Pride Teyim², Beh Frankline Dang³

¹Center for Health Promotion and Research, Bamenda, Northwest, Cameroon. vuchascommy@gmail.com.

Scientific reports

|September 16, 2023

概括

聚合测试显著提高了结核病 (TB) 诊断效率. 这种方法节省了48%的分子测试,使得成千上万的结核病患者能够进行快速测试.

科学领域:

微生物学微生物学
公共卫生公共卫生
诊断技术诊断技术诊断技术

背景情况:

在全球范围内,每年有数以百万计的结核病患者没有被诊断和治疗.
世界卫生组织建议快速分子测试用于结核病诊断,但高成本限制了它们的使用.
对其他疾病有效的聚合测试在结核病诊断中未得到充分利用.

研究的目的:

通过使用Xpert MTB/RIF和Xpert MTB/RIF Ultra测定来评估结核病诊断的聚合测试的效率和准确性.
评估聚合测试对测试利用和患者在资源有限的环境中的影响.

主要方法:

使用聚合的Xpert MTB/RIF和Xpert MTB/RIF Ultra试验 (2020年7月至2022年2月) 测试的10,117个唾液样本的回顾性分析.
在基分析中估计了聚合测试 (3个池) 与Xpert MTB/RIF Ultra.个人测试的积极百分比一致性.

主要成果:

聚合测试使测试使用量减少了48%,并为额外的4156人提供了快速分子测试.
检测样本中的结核病患病率为6.6%.
在 silico 分析中估计,聚合测试的阳性百分比一致性为 99.4% (95% CI, 96.6% 100%) 对于 Xpert MTB/RIF Ultra.

结论:

聚合测试是结核病诊断的高效策略,大大节省了分子测试.
该方法扩大了快速分子诊断的可用性,这对于提高结核病例检测率至关重要.
结果支持广泛实施聚合测试,以加强全球结核病诊断工作.

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