Low-cost diagnostic test for susceptible and drug-resistant tuberculosis in rural Malawi

Jumbe, Enoch; Torrelles, Jordi B.; Mwapasa, Victor; Norris, Alison; Kelley, Holden V.; Garcia, Juan I.; Chemey, Elly K.; Pan, Xueliang J.; Wang, Shu-Hua; Kamba, Chancy; Sidiki, Sabeen; Zhang, Annie; Krysiak, Robert; Evans, Carlton Anthony William; Kwiek, Jesse J.

dc.contributor.author	Zhang, Annie
dc.contributor.author	Jumbe, Enoch
dc.contributor.author	Krysiak, Robert
dc.contributor.author	Sidiki, Sabeen
dc.contributor.author	Kelley, Holden V.
dc.contributor.author	Chemey, Elly K.
dc.contributor.author	Kamba, Chancy
dc.contributor.author	Mwapasa, Victor
dc.contributor.author	Garcia, Juan I.
dc.contributor.author	Norris, Alison
dc.contributor.author	Pan, Xueliang J.
dc.contributor.author	Evans, Carlton Anthony William
dc.contributor.author	Wang, Shu-Hua
dc.contributor.author	Kwiek, Jesse J.
dc.contributor.author	Torrelles, Jordi B.
dc.date.accessioned	2018-12-01T00:04:14Z
dc.date.available	2018-12-01T00:04:14Z
dc.date.issued	2018
dc.identifier.uri	https://hdl.handle.net/20.500.12866/4247
dc.description.abstract	Background: Rural settings where molecular tuberculosis diagnostics are not currently available need easy-to-use tests that do not require additional processing or equipment. While acid-fast bacilli (AFB) smear is the most common and often only tuberculosis diagnosis test performed in rural settings, it is labour intensive, has less-than-ideal sensitivity, and cannot assess tuberculosis drug susceptibility patterns. Objective: The objective of this study was to determine the feasibility of a multidrugresistant (MDR) or extensively drug-resistant (XDR)-tuberculosis coloured agar-based culture test (tuberculosis CX-test), which can detect Mycobacterium tuberculosis growth and evaluate for drug susceptibility to isoniazid, rifampicin and a fluoroquinolone (i. e. ciprofloxacin) in approximately 14 days. Method: In this study, 101 participants were enrolled who presented to a rural health clinic in central Malawi. They were suspected of having active pulmonary tuberculosis. Participants provided demographic and clinical data and submitted sputum samples for tuberculosis testing using the AFB smear and tuberculosis CX-test. Results: The results showed a high level of concordance between the AFB smear (12 positive) and tuberculosis CX-test (13 positive); only one sample presented discordant results, with the molecular GeneXpert MTB/RIF (R) test confirming the tuberculosis CX-test results. The average time to a positive tuberculosis CX-test was 10 days. Of the positive samples, the tuberculosis CXtest detected no cases of drug resistance, which was later confirmed by the GeneXpert MTB/RIF (R). Conclusion: These findings demonstrate that the tuberculosis CX-test could be a reliable low-cost diagnostic method for active pulmonary tuberculosis in high tuberculosis burden rural areas.	en_US
dc.language.iso	eng
dc.publisher	African Online Scientific Information Systems
dc.relation.ispartofseries	African Journal of Laboratory Medicine
dc.rights	info:eu-repo/semantics/restrictedAccess
dc.subject	Tuberculosis	en_US
dc.subject	Mycobacterium tuberculosis	en_US
dc.subject	diagnosis	en_US
dc.subject	drug resistance	en_US
dc.title	Low-cost diagnostic test for susceptible and drug-resistant tuberculosis in rural Malawi	en_US
dc.type	info:eu-repo/semantics/article
dc.identifier.doi	https://doi.org/10.4102/ajlm.v7i1.690
dc.subject.ocde	https://purl.org/pe-repo/ocde/ford#1.06.03
dc.subject.ocde	https://purl.org/pe-repo/ocde/ford#2.06.02
dc.relation.issn	2225-2010