title: Xpert(®) MTB/RIF under routine conditions in diagnosing pulmonary tuberculosis: a study in two hospitals in Pakistan.
abstract: Xpert(®) MTB/RIF testing was offered to consecutive patients with presumptive tuberculosis (TB) attending two hospitals in Pakistan during April-May 2012, in addition to routine diagnostic protocol (smear microscopy, chest radiography and clinical judgement). We assessed the relative contribution of each tool in detecting pulmonary TB under routine conditions. Of 606 participants, 121 (20%) were detected as pulmonary TB: 46 (38%) by microscopy, 38 (31%) by Xpert alone and 37 (31%) on clinical and radiological grounds; 41 (65%) were detected by both Xpert and microscopy. One patient had rifampicin resistance. Although Xpert detected approximately twice as many TB cases as microscopy (n = 79, 65%), clinical judgement remained favoured by clinicians even when smear and Xpert were negative.
authors.affiliation: Department of Health Sciences, University of York, York, UK.
authors.forename: S K
authors.initials: SK
authors.lastname: Shah
authors.affiliation: International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India.
authors.forename: A M V
authors.initials: AM
authors.lastname: Kumar
authors.affiliation: Department of Health Sciences, University of York, York, UK.
authors.forename: O F
authors.initials: OF
authors.lastname: Dogar
authors.affiliation: Association for Social Development, Islamabad, Pakistan.
authors.forename: M A
authors.initials: MA
authors.lastname: Khan
authors.affiliation: National Tuberculosis Programme, Islamabad, Pakistan.
authors.forename: E
authors.initials: E
authors.lastname: Qadeer
authors.affiliation: National Tuberculosis Programme, Islamabad, Pakistan.
authors.forename: S
authors.initials: S
authors.lastname: Tahseen
authors.affiliation: National Tuberculosis Programme, Islamabad, Pakistan.
authors.forename: F
authors.initials: F
authors.lastname: Masood
authors.affiliation: Health Services Academy, Islamabad, Pakistan.
authors.forename: A K
authors.initials: AK
authors.lastname: Chandio
authors.affiliation: The Union, Paris, France.
authors.forename: M E
authors.initials: ME
authors.lastname: Edginton
keywords: Pakistan; Xpert MTB/RIF; diagnosis; operational research; tuberculosis