# name
Do Xpert MTB/RIF Cycle Threshold Values Provide Information
                about Patient Delays for Tuberculosis Diagnosis?

# metadata.dc.description.abstract[].value
INTRODUCTION: Early diagnosis and initiation to appropriate
                treatment is vital for tuberculosis (TB) control. The
                XpertMTB/RIF (Xpert) assay offers rapid TB diagnosis and
                quantitative estimation of bacterial burden through Cycle
                threshold (Ct) values. We assessed whether the Xpert Ct value is
                associated with delayed TB diagnosis as a potential monitoring
                tool for TB control programme performance. MATERIALS AND
                METHODS: This analysis was nested in a prospective study under
                the routine TB surveillance procedures of the National TB
                Control Program in Manhica district, Maputo province,
                Mozambique. Presumptive TB patients were tested using smear
                microscopy and Xpert. We explored the association between Xpert
                Ct values and self-reported delay of Xpert-positive TB patients
                as recorded at the time of diagnosis enrolment. Patients with
                >60 days of TB symptoms were considered to have long delays.
                RESULTS: Of 1,483 presumptive TB cases, 580 were diagnosed as TB
                of whom 505 (87.0%) were due to pulmonary TB and 302 (94.1%)
                were Xpert positive. Ct values (range, 9.7-46.4) showed a
                multimodal distribution. The median (IQR) delay was 30 (30-45)
                days. Ct values showed no correlation with delay (R2 = 0.001, p
                = 0.621), nor any association with long delays: adjusted odds
                ratios (AOR) (95% confidence interval [CI]) comparing to >28
                cycles 0.99 (0.50-1.96; p = 0.987) for 23-28 cycles, 0.93
                (0.50-1.74; p = 0.828) for 16-22 cycles; and 1.05 (0.47-2.36; p
                = 0.897) for <16 cycles. Being HIV-negative (AOR [95% CI]),
                2.05 (1.19-3.51, p = 0.009) and rural residence 1.74 (1.08-2.81,
                p = 0.023), were independent predictors of long delays.
                CONCLUSION: Xpert Ct values were not associated with patient
                delay for TB diagnosis and cannot be used as an indicator of TB
                control program performance.

# metadata.dc.relation.isformatof[].value
Reproducció del document publicat a:
                http://dx.doi.org/10.1371/journal.pone.0162833

# metadata.dc.source[].value
Articles publicats en revistes (ISGlobal)

# metadata.dc.title[].value
Do Xpert MTB/RIF Cycle Threshold Values Provide Information
                about Patient Delays for Tuberculosis Diagnosis?