DSpace Repository

Low implementation of Xpert MTB/RIF among HIV/TB co-infected adults in the International epidemiologic Databases to Evaluate AIDS (IeDEA) program

Show simple item record

dc.contributor.author Clouse, K.
dc.contributor.author Blevins, M.
dc.contributor.author Lindegren, M.L.
dc.contributor.author Yotebieng, M.
dc.contributor.author Nguyen, D.T.
dc.contributor.author Omondi, A.
dc.contributor.author Michael, D.
dc.contributor.author Zannou, D.M.
dc.contributor.author Carriquiry, G.
dc.contributor.author Pettit, A.
dc.contributor.author IeDEA
dc.contributor.author Gotuzzo, E.
dc.contributor.author Mejia, F.
dc.contributor.author Carriquiry, G.
dc.date.accessioned 2019-04-24T18:23:56Z
dc.date.available 2019-04-24T18:23:56Z
dc.date.issued 2017
dc.identifier.uri https://hdl.handle.net/20.500.12866/6488
dc.description.abstract Objective: Xpert MTB/RIF is recommended by the World Health Organization (WHO) as the initial tuberculosis (TB) diagnostic test in individuals suspected of HIV-associated TB. We sought to evaluate field implementation of Xpert among a cohort of HIV/TB co-infected individuals, including availability, utilization and outcomes. Design: Observational cohort study (patient-level data) and cross-sectional study (site-level Xpert availability data). Methods: Data were collected at 30 participating International epidemiologic Databases to Evaluate AIDS (IeDEA) sites in 18 countries from January 2012-January 2016. All patients were HIV-infected and diagnosed with TB, either bacteriologically or clinically, and followed until a determination of TB treatment outcome. We used multivariable modified Poisson regression to estimate adjusted relative risk (RR) and 95% confidence intervals for unfavorable TB treatment outcomes. Results: Most sites (63%) had access to Xpert, either in the clinic (13%), in the same facility (20%) or offsite (30%). Among 2722 HIV/TB patients included, median age was 35.4 years and 41% were female; BMI and CD4 count were low. Overall, most patients (76%) received at least one TB test; 45% were positive. Only 4% of all patients were tested using Xpert: 64% were Xpert-positive, 13% showed rifampicin (RIF) resistance and 30% were extrapulmonary (EPTB) or both pulmonary-EPTB. Treatment outcomes were mostly favorable (77%) and we found little association between Xpert use and an unfavorable TB treatment outcome (RR 1.25, 95%CI: 0.83, 1.90). Conclusions: In this cohort, Xpert utilization was low even though the majority of sites had access to the test. Our findings show the need for expanded implementation and further research exploring barriers to use in low-resource settings. en_US
dc.language.iso eng
dc.publisher PLoS
dc.relation.ispartof urn:issn:1932-6203
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject antiretrovirus agent en_US
dc.subject CD4 antigen en_US
dc.subject rifampicin en_US
dc.subject tuberculostatic agent en_US
dc.subject adult en_US
dc.subject antibiotic resistance en_US
dc.subject Article en_US
dc.subject bacterium culture en_US
dc.subject bacterium identification en_US
dc.subject body mass en_US
dc.subject CD4 lymphocyte count en_US
dc.subject clinical practice en_US
dc.subject cohort analysis en_US
dc.subject confidence interval en_US
dc.subject cross-sectional study en_US
dc.subject extrapulmonary tuberculosis en_US
dc.subject female en_US
dc.subject health care access en_US
dc.subject health care facility en_US
dc.subject health program en_US
dc.subject human en_US
dc.subject Human immunodeficiency virus infection en_US
dc.subject information processing en_US
dc.subject lung tuberculosis en_US
dc.subject major clinical study en_US
dc.subject male en_US
dc.subject mixed infection en_US
dc.subject nucleic acid amplification en_US
dc.subject observational study en_US
dc.subject rapid test en_US
dc.subject regression analysis en_US
dc.subject risk assessment en_US
dc.subject sputum smear en_US
dc.subject treatment outcome en_US
dc.subject Acquired Immunodeficiency Syndrome en_US
dc.subject Coinfection en_US
dc.subject complication en_US
dc.subject factual database en_US
dc.subject HIV Infections en_US
dc.subject Human immunodeficiency virus 1 en_US
dc.subject international cooperation en_US
dc.subject Tuberculosis, Multidrug-Resistant en_US
dc.subject Acquired Immunodeficiency Syndrome en_US
dc.subject Adult en_US
dc.subject Cohort Studies en_US
dc.subject Coinfection en_US
dc.subject Cross-Sectional Studies en_US
dc.subject Databases, Factual en_US
dc.subject Female en_US
dc.subject HIV Infections en_US
dc.subject HIV-1 en_US
dc.subject Humans en_US
dc.subject Internationality en_US
dc.subject Male en_US
dc.subject Tuberculosis, Multidrug-Resistant en_US
dc.title Low implementation of Xpert MTB/RIF among HIV/TB co-infected adults in the International epidemiologic Databases to Evaluate AIDS (IeDEA) program en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1371/journal.pone.0171384
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.00 es_PE
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.03.09
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.03.08


Files in this item

Files Size Format View

There are no files associated with this item.

This item appears in the following Collection(s)

Show simple item record

info:eu-repo/semantics/restrictedAccess Except where otherwise noted, this item's license is described as info:eu-repo/semantics/restrictedAccess

Search DSpace


Browse

My Account

Statistics