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Saavedra B, Mambuque E, Gomes N, Nguenha D, Mabunda R, Faife L, Langa R, Munguambe S, Manjate F, Cossa A, Scott L, García-Basteiro AL. Diagnostic performance of the Abbott RealTime MTB assay for tuberculosis diagnosis in people living with HIV. Sci Rep 2021; 11:19271. [PMID: 34588508 PMCID: PMC8481474 DOI: 10.1038/s41598-021-96922-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 08/02/2021] [Indexed: 11/09/2022] Open
Abstract
Strengthening tuberculosis diagnosis is an international priority and the advocacy for multi-disease testing devices raises the possibility of improving laboratory efficiency. However, the advantages of centralized platforms might not translate into real improvements under operational conditions. This study aimed to evaluate the field use of the Abbott RealTime MTB (RT-MTB) and Xpert MTB/RIF assays, in a large cohort of HIV-positive and TB presumptive cases in Southern Mozambique. Over a 6-month period, 255 HIV-positive TB presumptive cases were consecutively recruited in the high TB/HIV burden district of Manhiça. The diagnostic performance of both assays was evaluated against two different reference standards: a microbiological gold standard (MGS) and a composite reference standard (CRS). Results from the primary analysis (MGS) showed improved sensitivity (Se) and reduced specificity (Sp) for the Abbott RT-MTB assay compared to the Xpert MTB/RIF (RT-MTB Se: 0.92 (95% CI: 0.75;0.99) vs Xpert Se: 0.73 (95% CI: 0.52;0.88) p value = 0.06; RT-MTB Sp: 0.80 (0.72;0.86) vs Xpert Sp: 0.96 (0.92;0.99) p value < 0.001). The lower specificity may be due to cross-reactivity with non-tuberculous mycobacteria (NTMs), the detection of non-viable MTBC, or the identification of true TB cases missed by the gold standard.
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Affiliation(s)
- Belén Saavedra
- PhD Program in Medicine and Translational Research, Universitat de Barcelona, Barcelona, Spain.
- Centro de Investigação Em Saude de Manhiça (CISM), Maputo, Mozambique.
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain.
| | - Edson Mambuque
- Centro de Investigação Em Saude de Manhiça (CISM), Maputo, Mozambique
| | - Neide Gomes
- Centro de Investigação Em Saude de Manhiça (CISM), Maputo, Mozambique
| | - Dinis Nguenha
- Centro de Investigação Em Saude de Manhiça (CISM), Maputo, Mozambique
| | - Rita Mabunda
- Centro de Investigação Em Saude de Manhiça (CISM), Maputo, Mozambique
| | - Luis Faife
- Manhiça Health Research Hospital, Ministry of Health, National Tuberculosis Control Program, Maputo, Mozambique
| | - Ruben Langa
- Manhiça Health Research Hospital, Ministry of Health, National Tuberculosis Control Program, Maputo, Mozambique
| | - Shilzia Munguambe
- Centro de Investigação Em Saude de Manhiça (CISM), Maputo, Mozambique
| | - Filomena Manjate
- Centro de Investigação Em Saude de Manhiça (CISM), Maputo, Mozambique
| | - Anelsio Cossa
- Centro de Investigação Em Saude de Manhiça (CISM), Maputo, Mozambique
| | - Lesley Scott
- Department of Molecular Medicine and Haematology, School of Pathology, and iLEAD, Faculty of Health Sciences, Wits Health Consortium, University of the Witwatersrand, Johannesburg, South Africa
| | - Alberto L García-Basteiro
- Centro de Investigação Em Saude de Manhiça (CISM), Maputo, Mozambique
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
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