title: [Use of the Xpert®MTB/RIF test in routine screening of new cases of pulmonary tuberculosis in an endemic area].
abstract: BACKGROUND
  Developed initially for the diagnosis of multidrug-resistant tuberculosis, the Xpert®MTB/RIF test has shown to be useful for the diagnosis of tuberculosis, especially among HIV-infected subjects. The objective of the study was to determine the contribution of the Xpert®MTB/RIF test for routine pulmonary tuberculosis diagnosis in an endemic area.
  
  
  METHODS
  We undertook a prospective study among patients presenting with cough and sputum. The sputum was submitted to microscopic examination, to the Xpert®MTB/RIF test and cultured by the Mycobacteria growth indicator tube (MGIT) technique. The study compared cases of pulmonary tuberculosis confirmed by a positive sputum culture and cases with cough but negative sputum culture.
  
  
  RESULTS
  In multivariate analysis, the factors associated with positive cultures were the following: male gender, cough for more than 2 weeks, loss of weight and fever. The estimated clinical suspicion score consisted of 4 signs each having a coefficient of 1. The sensitivity of each clinical sign varied between 79 and 94%. In 348 cases of negative microscopic examination (composed of 295 cases with score<4 and 53 cases with score=4), the predictive positive value of the Xpert®MTB/RIF was 80% for a score equal to 4 and 40.9% for a score<4. In cases of negative microscopic examination of the sputum, the Xpert®MRT/RIF test should be undertaken if the score=4.
  
  
  CONCLUSIONS
  The diagnosis of tuberculosis in endemic zones could be improved by using the Xpert®MTB/RIF.
authors.affiliation: Service de pneumologie, CHU de Cocody, BP 582, Abidjan cedex 03, Côte d'Ivoire. Electronic address: kigninlmanh@yahoo.fr.
authors.forename: K
authors.initials: K
authors.lastname: Horo
authors.affiliation: Service de mycobactérie, institut Pasteur d'Abidjan, Abidjan, Côte d'Ivoire.
authors.forename: R
authors.initials: R
authors.lastname: N'Guessan
authors.affiliation: Service de pneumologie, CHU de Cocody, BP 582, Abidjan cedex 03, Côte d'Ivoire.
authors.forename: M-O
authors.initials: MO
authors.lastname: Koffi
authors.affiliation: CAT de Yopougon, FSUCOM de Wassakara de Yopougon, Abidjan, Côte d'Ivoire.
authors.forename: N
authors.initials: N
authors.lastname: Kouamé-N'Takpé
authors.affiliation: Service de pneumologie, CHU de Cocody, BP 582, Abidjan cedex 03, Côte d'Ivoire.
authors.forename: A
authors.initials: A
authors.lastname: Koné
authors.affiliation: Service de pneumologie, CHU de Cocody, BP 582, Abidjan cedex 03, Côte d'Ivoire.
authors.forename: K
authors.initials: K
authors.lastname: Samaké
authors.affiliation: Service de pneumologie, CHU de Cocody, BP 582, Abidjan cedex 03, Côte d'Ivoire.
authors.forename: L
authors.initials: L
authors.lastname: Koffi
authors.affiliation: Service de pneumologie, CHU de Cocody, BP 582, Abidjan cedex 03, Côte d'Ivoire.
authors.forename: B J M
authors.initials: BJM
authors.lastname: Ahui
authors.affiliation: Service de pneumologie, CHU de Cocody, BP 582, Abidjan cedex 03, Côte d'Ivoire.
authors.forename: C V
authors.initials: CV
authors.lastname: Brou-Gode
authors.affiliation: Service de pneumologie, CHU de Cocody, BP 582, Abidjan cedex 03, Côte d'Ivoire.
authors.forename: A
authors.initials: A
authors.lastname: N'Gom
authors.affiliation: Service de pneumologie, CHU de Cocody, BP 582, Abidjan cedex 03, Côte d'Ivoire.
authors.forename: B A
authors.initials: BA
authors.lastname: Kouassi
authors.affiliation: Service de pneumologie, CHU de Cocody, BP 582, Abidjan cedex 03, Côte d'Ivoire.
authors.forename: N
authors.initials: N
authors.lastname: Koffi
authors.affiliation: Service de pneumologie, CHU de Cocody, BP 582, Abidjan cedex 03, Côte d'Ivoire.
authors.forename: E
authors.initials: E
authors.lastname: Aka-Danguy
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001431:Bacteriological Techniques / Q000379:methods*; D003937:Diagnosis, Differential; D003955:Diagnostic Tests, Routine / Q000379:methods*; D019353:Endemic Diseases / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D013183:Sputum / Q000382:microbiology*; D018088:Tuberculosis, Multidrug-Resistant / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology; D055815:Young Adult
keywords: Diagnosis; Diagnostic; Dépistage; Screening; Tuberculose; Tuberculosis; Xpert(®) MTB/RIF