title: Evaluation of the implementation of the Xpert® MTB/RIF assay in Fiji.
abstract: METHODS
  All Xpert® MTB/RIF tests performed in the three TB (tuberculosis) treatment centres in Fiji from June 2012 to February 2013.
  
  
  OBJECTIVE
  To determine 1) the number of Xpert tests performed in each centre, 2) the association between sputum quality and Xpert results, 3) the agreement of Xpert with acid-fast bacilli (AFB) smear microscopy and TB culture and 4) error rates.
  
  
  METHODS
  Retrospective review of records.
  
  
  RESULTS
  A total of 415 Xpert tests were performed in the study period. Mycobacterium tuberculosis was detected in 69 (16.6%) samples. No rifampicin resistance was detected. M. tuberculosis was detected from 60 (18.7%) good-quality sputum samples. A total of 43 (10.4%) errors occurred during this period. M. tuberculosis was detected in 10 (2.9%) smear-negative specimens. There was a substantial and an almost perfect agreement between Xpert and AFB microscopy (κ = 0.793) and culture results (κ = 0.818), respectively.
  
  
  CONCLUSIONS
  Although a good correlation between Xpert and the two tests were shown in the study, Xpert should not replace the routine first-line TB diagnostic tests used in Fiji for reasons related to logistics and sustainability. A further evaluation of the assay's performance is required over a longer time period to gauge its diagnostic value in detecting smear-negative, Xpert-positive cases in Fiji.
authors.affiliation: National Tuberculosis Program, Ministry of Health, Suva, Fiji.
authors.forename: A
authors.initials: A
authors.lastname: Gounder
authors.affiliation: National Tuberculosis Program, Ministry of Health, Suva, Fiji.
authors.forename: S
authors.initials: S
authors.lastname: Gounder
authors.affiliation: School of Population Health, The University of Queensland, Brisbane, Queensland, Australia.
authors.forename: S A
authors.initials: SA
authors.lastname: Reid
keywords: Mycobacterium tuberculosis; Xpert® MTB/RIF; evaluation; rifampicin