Xpert MTB/RIF versus sputum microscopy as the initial diagnostic test for tuberculosis: a cluster-randomised trial embedded in South African roll-out of Xpert MTB/RIF

by Gavin J Churchyard, Wendy S Stevens, Lerole D Mametja et al.
Lancet Glob Health 2015; 3: e450–57

8 pp. 198 kB

In South Africa, sputum smear microscopy has been replaced with Xpert MTB/RIF as the initial diagnostic test for tuberculosis. In a pragmatic parallel cluster-randomised trial, the authors evaluated the effect on patient and programme outcomes. They conclude that Xpert did not reduce mortality at 6 months compared with sputum microscopy. Improving outcomes in drug-sensitive tuberculosis programmes might require not only better diagnostic tests but also better linkage to care.

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