title: The Use of Xpert MTB/Rif for Active Case Finding among TB Contacts in North West Province, South Africa.
abstract: Introduction. Tuberculosis is a major cause of morbidity and mortality especially in high HIV burden settings. Active case finding is one strategy to potentially reduce TB disease burden. Xpert MTB/Rif has recently been recommended for diagnosis of TB. Methods. Pragmatic randomized trial to compare diagnosis rate and turnaround time for laboratory testing for Xpert MTB/Rif with TB microscopy and culture in household contacts of patients recently diagnosed with TB. Results. 2464 household contacts enrolled into the study from 768 active TB index cases. 1068 (44%) were unable to give sputum, but 24 of these were already on TB treatment. 863 (53%) participants sputum samples were tested with smear and culture and 2.7% (23/863; CI: 1.62-3.78) were diagnosed with active TB. Xpert MTB/Rif was used in 515 (21%) participants; active TB was diagnosed in 1.6% (8/515; CI: 0.52-2.68). Discussion and Conclusions. Additional 31 cases were diagnosed with contact tracing of household members. When Xpert MTB/Rif is compared with culture, there is no significant difference in diagnostic yield.
authors: Perinatal HIV Research Unit, University of Witwatersrand, Johannesburg 2000, South Africa.
authors: Limakatso
authors: 0000-0001-6825-0573
authors: L
authors: Lebina
authors: Public Health, School of Medicine, University of Liverpool, Liverpool L69 7ZX, UK.
authors: Nigel
authors: 0000-0003-0120-9378
authors: N
authors: Fuller
authors: Public Health, School of Medicine, University of Liverpool, Liverpool L69 7ZX, UK.
authors: Tolu
authors: T
authors: Osoba
authors: Department of Molecular Medicine and Hematology, University of the Witwatersrand, Johannesburg 2000, South Africa.
authors: Lesley
authors: L
authors: Scott
authors: Perinatal HIV Research Unit, University of Witwatersrand, Johannesburg 2000, South Africa.
authors: Katlego
authors: K
authors: Motlhaoleng
authors: Perinatal HIV Research Unit, University of Witwatersrand, Johannesburg 2000, South Africa.
authors: Modiehi
authors: M
authors: Rakgokong
authors: Perinatal HIV Research Unit, University of Witwatersrand, Johannesburg 2000, South Africa.
authors: Pattamukkil
authors: 0000-0001-6776-5129
authors: P
authors: Abraham
authors: Department of Internal Medicine, Klerksdorp/Tshepong Hospital Complex, North West Department of Health and University of the Witwatersrand, Johannesburg 2000, South Africa.
authors: Ebrahim
authors: 0000-0003-2888-789X
authors: E
authors: Variava
authors: Perinatal HIV Research Unit, University of Witwatersrand, Johannesburg 2000, South Africa; DST/NRF Centre of Excellence for Biomedical TB Research, University of the Witwatersrand, Johannesburg 2000, South Africa.
authors: Neil Alexander
authors: NA
authors: Martinson