title: Evaluation of OMNIgene®•SPUTUM-stabilised sputum for long-term transport and Xpert® MTB/RIF testing in Nepal.
abstract: German Nepal TB Project, National Tuberculosis Reference Laboratory, Kathmandu, Nepal.
  
  
  
  To evaluate whether transporting samples in OMNIgene®•SPUTUM (OM-S) reagent from a peripheral collection site to a central laboratory in Nepal can improve tuberculosis (TB) detection and increase the sensitivity of Xpert® MTB/RIF testing.
  
  
  
  One hundred sputum samples were split manually. Each portion was assigned to the OM-S group (OM-S added at collection, airline-couriered without cold chain, no other processing required) or the standard-of-care (SOC) group (samples airline-couriered on ice, sodium hydroxide + N-acetyl-L-cysteine processing required at the laboratory). Smear microscopy and Xpert testing were performed.
  
  
  
  Transport time was 2-13 days. Overall smear results were comparable (respectively 58% and 56% smear-negative results in the OM-S and SOC groups). The rate of smear-positive, Mycobacterium tuberculosis-positive (MTB+) sample detection was identical for both treatment groups, at 95%. More smear-negative MTB+ samples were detected in the OM-S group (17% vs. 13%, P = 0.0655).
  
  
  
  Sputum samples treated with OM-S can undergo multiday ambient-temperature transport and yield comparable smear and Xpert results to those of SOC samples. Further investigation with larger sample sizes is required to assess whether treating sputum samples with OM-S could increase the sensitivity of Xpert testing in smear-negative samples.
authors.affiliation: German Nepal TB Project (GENETUP)/Nepal Anti-Tuberculosis Association, Kathmandu, Nepal.
authors.forename: B
authors.initials: B
authors.lastname: Maharjan
authors.affiliation: DNA Genotek, Ottawa, Ontario, Canada.
authors.forename: C D
authors.initials: CD
authors.lastname: Kelly-Cirino
authors.affiliation: DNA Genotek, Ottawa, Ontario, Canada.
authors.forename: A
authors.initials: A
authors.lastname: Weirich
authors.affiliation: DNA Genotek, Ottawa, Ontario, Canada.
authors.forename: P S
authors.initials: PS
authors.lastname: Curry
authors.affiliation: Kuratorium Tuberkulose in der Welt, München-Gauting, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Hoffman
authors.affiliation: Kuratorium Tuberkulose in der Welt, München-Gauting, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Avsar
authors.affiliation: German Nepal TB Project (GENETUP)/Nepal Anti-Tuberculosis Association, Kathmandu, Nepal.
authors.forename: B
authors.initials: B
authors.lastname: Shrestha
mesh_terms: D006801:Humans; D025202:Molecular Diagnostic Techniques; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D009390:Nepal; D011897:Random Allocation; D012034:Refrigeration; D012680:Sensitivity and Specificity; D013048:Specimen Handling / Q000379:methods*; D013183:Sputum / Q000382:microbiology*; D014376:Tuberculosis / Q000175:diagnosis*