BMC Infectious Diseases | |
Test and Treat TB: a pilot trial of GeneXpert MTB/RIF screening on a mobile HIV testing unit in South Africa | |
Sabina Govere1  Bright Mhlongo1  Hilary Thulare1  Leah S. Forman2  Ingrid V. Bassett3  Elena Losina4  Simone C. Frank4  | |
[1] AIDS Healthcare Foundation;Data Coordinating Center, Boston University School of Public Health;Division of Infectious Disease, Massachusetts General Hospital;Medical Practice Evaluation Center, Department of Medicine, Massachusetts General Hospital; | |
关键词: Tuberculosis; Test & Treat; GeneXpert MTB/RIF; Community-based screening; | |
DOI : 10.1186/s12879-019-3738-4 | |
来源: DOAJ |
【 摘 要 】
Abstract Background Community-based GeneXpert MTB/RIF testing may increase detection of prevalent TB in the community and improve rates of TB treatment completion. Methods We conducted a pilot randomized trial to evaluate the impact of GeneXpert screening on a mobile HIV testing unit. Adults (≥18y) underwent rapid HIV testing and TB symptom screening and were randomized to usual mobile unit care (providing sputum on the mobile unit sent out for GeneXpert testing) or the “Test & Treat TB” intervention with immediate GeneXpert testing. Symptomatic participants in usual care produced sputum that was sent for hospital-based GeneXpert testing; participants were contacted ~ 7 days later with results. In the “Test & Treat TB” intervention, HIV-infected or HIV-uninfected/TB symptomatic participants underwent GeneXpert testing on the mobile unit. GeneXpert+ participants received expedited TB treatment initiation, monthly SMS reminders and non-cash incentives. We assessed 6-month TB treatment outcomes. Results 4815 were eligible and enrolled; median age was 27 years (IQR 22 to 35). TB symptoms included cough (5%), weight loss (4%), night sweats (4%), and fever (3%). 42% of eligible participants produced sputum (intervention: 56%; usual care: 26%). Seven participants tested GeneXpert+, six in the intervention (3%, 95% CI 1%, 5%) and one in usual care (1%, 95% CI 0%, 6%). 5 of 6 intervention participants completed TB treatment; the GeneXpert+ participant in usual care did not. Conclusion GeneXpert MTB/RIF screening on a mobile HIV testing unit is feasible. Yield for GeneXpert+ TB was low, however, the “Test & Treat TB” strategy led to high rates of TB treatment completion. Trial registration This study was registered on November 21, 2014 at ClinicalTrials.gov (NCT02298309).
【 授权许可】
Unknown