Browsing by Author "Reid, S. E."

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Accuracy of giant African pouched rats for diagnosing tuberculosis: comparison with culture and Xpert W MTB/RIF
(Researchgate, 2017) Mulder, C.; Mgode, G. F.; Ellis, H.; Valverde, E.; Beyene, N.; Cox, C.; Reid, S. E.; Van’t Hoog, A. H.; Edwards, T. L.
S E T T I N G : Enhanced tuberculosis (TB) case finding using detection rats in Tanzania. O B J E C T I V E S : To assess the diagnostic accuracy of detection rats compared with culture and Xpert w MTB/ RIF, and to compare enhanced case-finding algorithms using rats in smear-negative presumptive TB patients. D E S I G N : A fully paired diagnostic accuracy study in which sputum of new adult presumptive TB patients in Tanzania was tested using smear microscopy, 11 detection rats, culture and Xpert. R E S U LT S : Of 771 eligible participants, 345 (45%) were culture-positive for Mycobacterium tuberculosis, and 264 (34%) were human immunodeficiency virus (HIV) positive. The sensitivity of the detection rats was up to 75.1% (95%CI 70.1–79.5) when compared with cul- ture, and up to 81.8% (95%CI 76.0–86.5) when compared with Xpert, which was statistically signifi- cantly higher than the sensitivity of smear microscopy. Corresponding specificity was 40.6% (95%CI 35.9– 45.5) compared with culture. The accuracy of rat detection was independent of HIV status. Using rats for triage, followed by Xpert, would result in a statistically higher yield than rats followed by light- emitting diode fluorescence microscopy, whereas the number of false-positives would be significantly lower than when using Xpert alone. C O N C L U S I O N : Although detection rats did not meet the accuracy criteria as standalone diagnostic or triage testing for presumptive TB, they have additive value as a triage test for enhanced case finding among smear- negative TB patients if more advanced diagnostics are not available
Tuberculosis diagnostic technology: an African solution ... think rats
(AOSIS, 2017-03-31) Mulder, C.; Mgode, G.; Reid, S. E.
Introduction Tuberculosis has now gained ranking alongside HIV as one of the two leading causes of death from infectious diseases worldwide. 1 In 2014, it was estimated that 1.5 million people died as a result of and 9.6 million fell ill with tuberculosis. 1 Despite these alarming figures, efforts to reduce the annual tuberculosis incidence rate over the last decade have resulted in only a meagre 1.5% decline. 1 In order to reach the ambitious targets of the Sustainable Development Goals by 2030 of reducing tuberculosis deaths by 90%, reducing the tuberculosis incidence rate by 90%, and ensuring that no tuberculosis-affected family is facing catastrophic costs due to tuberculosis, a paradigm shift is urgently needed. 1 Recently, a series of papers was published in The Lancet on how to eliminate tuberculosis, suggesting repacking current interventions into a comprehensive control strategy. 2 The World Health Organization End TB Strategy supports this and also emphasises the need for better adoption and rapid uptake of new tools to diagnose tuberculosis earlier, the systematic screening of high-risk populations, and the effective and rapid roll-out of these strategies in highly-affected countries. 3 However, the practicality of achieving these components remains challenging because of the lack of a rapid, simple, accurate and affordable point-of-care diagnostic and screening algorithm that can be scaled-up to screen large numbers of individuals. Nevertheless, achievement of these goals is necessary and must catalyse the development of new interventions in Africa, for Africa, the continent with the highest tuberculosis mortality and morbidity rates.