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Table 3 Methods of new TB diagnosis immediately before ART and in the first 6 months of ART in the SOC, EC, and EC+X phases of XPRES

From: Effect of tuberculosis screening and retention interventions on early antiretroviral therapy mortality in Botswana: a stepped-wedge cluster randomized trial

 

SOC phase

EC phase

EC+X phase

 

n

%

n

%

n

%

Pulmonary TB

 Microbiologically confirmed pulmonary TB (smear microscopy in SOC and EC, Xpert during EC+X)

22

18

23

34

113

57

 Microbiologically confirmed pulmonary TB through culturea (missing or negative smear and Xpert)

0

0

12

18

16

8

 Clinical diagnosis of pulmonary TB with negative sputum test (negative smear, Xpert, or culture documented)

6b

5

6d

9

17f

9

 Clinical diagnosis of pulmonary TB with no documented sputum test result

95c

77

27e

40

52g

26

Sub-total pulmonary TB

123

100

68

100

198

100

All TB

 Pulmonary TB total

123

95

68

79

198

81

 Extra-pulmonary TB total

6

5

18

21

46

19

Total

129

100

86

100

244

100

  1. Abbreviations: SOC standard of care, EC enhanced care, EC+X enhanced care plus Xpert, TB tuberculosis, XPRES Xpert Package Rollout Evaluation using a Stepped-wedge design
  2. aTo meet other study objectives related to estimation of diagnostic accuracy of the smear microscopy-based and Xpert-based TB diagnostic algorithms, one spot sputum and the morning sputum were sent to the National TB Reference Laboratory (NTRL) for liquid culture in mycobacteria growth indicator tubes (MGIT). The liquid culture results were also returned to the clinics, although average turnaround times exceeding 49 days were expected per existing standard of care
  3. b5 (83%) of 6 had documentation that x-ray findings were suggestive of pulmonary TB
  4. c13 (14%) of 95 had documentation that x-ray findings were suggestive of pulmonary TB
  5. d3 (50%) of 6 had documentation that x-ray findings were suggestive of pulmonary TB
  6. e16 (59%) of 27 had documentation that x-ray findings were suggestive of pulmonary TB
  7. f8 (47%) of 17 had documentation that x-ray findings were suggestive of pulmonary TB
  8. g20 (38%) of 52 had documentation that x-ray findings were suggestive of pulmonary TB