title: Successes, challenges and lessons from a novel deployment of Xpert(®) MTB/RIF at a major South African public event [Short Communication].
abstract: In a mobile deployment of Xpert(®) MTB/RIF (Xpert) at the public event for 2012 South African World TB Day, Xpert testing was offered to tuberculosis (TB) symptomatic clients from gold mining and surrounding communities. Considerations before implementation included effective TB symptom screening; safe, effective sputum collection; uninterrupted electricity supply; stringent instrument verification and provision of on-site results. Public event Xpert testing is feasible; however, the case-finding rate was very low (0.7%). We recommend exploring enhanced symptom screening algorithms to improve pre-test probability, cost-effectiveness analysis, exploring alternate electrical fail-safes and on-site data connectivity and improving management of client expectations.
authors.affiliation: The Aurum Institute, Johannesburg, South Africa.
authors.forename: L
authors.initials: L
authors.lastname: Page-Shipp
authors.affiliation: National Health Laboratory Service, Johannesburg, South Africa.
authors.forename: W
authors.initials: W
authors.lastname: Stevens
authors.affiliation: The Aurum Institute, Johannesburg, South Africa.
authors.forename: D
authors.initials: D
authors.lastname: Clark
authors.affiliation: Department of Molecular Medicine and Haematology, University of the Witwatersrand, Cape Town, South Africa.
authors.forename: L
authors.initials: L
authors.lastname: Scott
authors.affiliation: National Health Laboratory Service, Johannesburg, South Africa.
authors.forename: F
authors.initials: F
authors.lastname: Olsen
authors.affiliation: The Aurum Institute, Johannesburg, South Africa.
authors.forename: H
authors.initials: H
authors.lastname: Kisbey-Green
authors.affiliation: National Department of Health, Pretoria, South Africa.
authors.forename: D
authors.initials: D
authors.lastname: Mametja
authors.affiliation: The Aurum Institute, Johannesburg, South Africa.
authors.forename: G
authors.initials: G
authors.lastname: Churchyard
mesh_terms: D001431:Bacteriological Techniques; D003153:Community Health Services / Q000458:organization & administration*; D004269:DNA, Bacterial / Q000235:genetics* / Q000302:isolation & purification; D005240:Feasibility Studies; D006297:Health Services Accessibility / Q000458:organization & administration; D006801:Humans; D008952:Mobile Health Units / Q000458:organization & administration*; D025202:Molecular Diagnostic Techniques; D009169:Mycobacterium tuberculosis / Q000235:genetics* / Q000302:isolation & purification; D010043:Outcome and Process Assessment, Health Care; D011237:Predictive Value of Tests; D015995:Prevalence; D015397:Program Evaluation; D013019:South Africa / Q000453:epidemiology; D013183:Sputum / Q000382:microbiology; D013997:Time Factors; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology
chemical_list: D004269:DNA, Bacterial