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Diagnosing Pulmonary Tuberculosis with the Xpert MTB/RIF Test
Published on: April 9, 2012
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基于便的Xpert测试用于诊断儿童和重症成人结核病
W Mwanza1, M Lutinala2, K Mundia3
1Ministry of Health, Lusaka, Zambia;, USAID-STAR Project, Washington DC, USA.
概括
基于便的Xpert MTB/RIF超级测试显著改善了赞比亚儿童的结核病诊断,增加了病例通知和确认率. 这种方法为无法提供唾液或胃吸附样本的儿童提供了一个重要的替代方案.
科学领域:
- 公共卫生 公共卫生
- 传染性疾病 传染性疾病
- 诊断 诊断 诊断 诊断
背景情况:
- 儿童肺结核 (TB) 诊断,特别是在资源有限的环境中,由于样本采集的困难,存在挑战.
- 唾液和胃吸液 (GA) 是常规样本,但对于儿科结核病诊断并不总是可行的.
- Xpert MTB/RIF Ultra (Xpert) 是一种用于结核病检测的快速分子测试.
研究的目的:
- 评估基于便的Xpert MTB/RIF Ultra测试在赞比亚诊断儿童结核病的常规实施和影响.
- 评估便样本作为或GA替代品的实用性,用于儿童和重症成人Xpert测试.
主要方法:
- 方法验证比较Xpert从便,唾液和GA标本的结果.
- 对基于便的Xpert测试的18个月例行实施数据的审查.
- 在实施前和实施后分析儿童结核病通知和细菌学确认率.
主要成果:
- 方法验证显示Xpert对便和常规样本的结果之间98.0%的一致性.
- 在18个月的时间里,16,210个便样本确定了157例儿童结核病病例和45例危急成人结核病例.
- 在0-4岁儿童中,便测试量明显超过GA测试 (10,288对2,459).
- 与2020年相比,2021年儿童结核病报告增加了30%,细菌学确认增加了53%.
结论:
- 常规的基于便的Xpert检测提高了无法产生或接受GA收集的儿童获得结核病诊断的机会.
- 实施导致儿童结核病的细菌学确认增加.
- 这种方法还为患有吐困难的重症成年人提供了快速测试的便利.
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