Equitable access to diagnostic resources means one Xpert-Ultra cartridge for all inpatients with HIV being investigated for tuberculosis

Authors

  • T Boyles Clinical HIV Research Unit, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, Wits Health Consortium, South Africa; London School of Hygiene and Tropical Medicine, London, UK
  • B Sossen Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa
  • S V Omar Centre for Tuberculosis, National and WHO Supranational TB Reference Laboratory, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa
  • G Meintjes Department of Medicine and Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, South Africa; Blizard Institute, Queen Mary University of London, UK
  • J Taljaard Division of Infectious Diseases, Department of Medicine, Tygerberg Hospital and Stellenbosch University, Cape Town, South Africa

DOI:

https://doi.org/10.7196/

Keywords:

Advanced HIV disease, GeneXpert MTB/RIF Ultra, Urine

Abstract

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References

1. World Health Organization. Global tuberculosis report 2023. Geneva: WHO, 2023.

2. Shapiro AE, Ross JM, Yao M, et al. Xpert MTB/RIF and Xpert Ultra assays for screening for pulmonary tuberculosis and rifampicin resistance in adults, irrespective of signs or symptoms. Cochrane Database Syst Rev 2021;3(3):CD013694. https://doi.org/10.1002/14651858.CD013694.

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3. Lawn SD, Nicol MP. Xpert MTB/RIF assay: Development, evaluation and implementation of a new rapid molecular diagnostic for tuberculosis and rifampicin resistance. Future Microbiol 2011;6(9):1067-1082. https://doi.org/10.2217/fmb.11.84

4. Boyles TH, Griesel R, Stewart A, Mendelson M, Maartens G. Incremental yield and cost of urine Determine TB-LAM and sputum induction in seriously ill adults with HIV. Int J Infect Dis 2018;75:67-73. https://doi.org/10.1016/j.ijid.2018.08.005

5. Bjerrum S, Schiller I, Dendukuri N, et al. Lateral flow urine lipoarabinomannan assay for detecting active tuberculosis in people living with HIV. Cochrane Database Syst Rev 2019;10(10):CD011420. https://doi.org/10.1002/14651858.CD011420.pub3

6. Broger T, Koeppel L, Huerga H, et al. TBYield Study Consortium. Diagnostic yield of urine lipoarabinomannan and sputum tuberculosis tests in people living with HIV: A systematic review and meta-analysis of individual participant data. Lancet Glob Health 2023;11(6):e903-e916. https:// doi.org/10.1016/S2214-109X(23)00135-3

7. World Health Organization. WHO consolidated guidelines on tuberculosis. Module 3: Diagnosis – rapid diagnostics for tuberculosis detection. 3rd ed. Geneva: WHO, 2024.

8. Ndege R, Rohacek M, Bani F, et al. Diagnostic yield of urine Xpert MTB/RIF Ultra in adults with suspected extrapulmonary tuberculosis. Open Forum Infect Dis 2024;11(7):ofae338. https://doi. org/10.1093/ofid/ofae338

9. Sossen B, Székely R, Mukoka M, et al.; FujiLAM Study Consortium. Urine-Xpert Ultra for the diagnosis of tuberculosis in people living with HIV: A prospective, multicentre, diagnostic accuracy study. Lancet Glob Health 2024;12(12):e2024-2034. https://doi.org/10.1016/S2214-109X(24)00357-7

10. World Health Organization. Updated recommendations on HIV and TB services. Geneva: WHO, 2021.

11. Reddy KP, Gupta-Wright A, Fielding KL, et al. Cost-effectiveness of urine-based tuberculosis screening in hospitalised patients with HIV in Africa: A microsimulation modelling study. Lancet Glob Health 2019;7(2):e200-e208. https://doi.org/10.1016/S2214-109X(18)30436-4

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Published

2025-05-02

Issue

SAMJ Vol. 115 no. 4

Section

Editorials

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Copyright (c) 2025 T Boyles, B Sossen, S V Omar, G Meintjes, J Taljaard

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How to Cite

1.
Boyles T, Sossen B, Omar SV, Meintjes G, Taljaard J. Equitable access to diagnostic resources means one Xpert-Ultra cartridge for all inpatients with HIV being investigated for tuberculosis. S Afr Med J [Internet]. 2025 May 2 [cited 2025 May 13];115(4):e3102. Available from: https://samajournals.co.za/index.php/samj/article/view/3102