Pooling sputum samples for Xpert® MTB/RIF and Xpert® Ultra testing for TB diagnosis

J. S. Bimba; O. A. Adekeye; Vibol Iem; T. T. Eliya; I. Osagie; Nadia Kontogianni; Thomas Edwards; James Dodd; Bertie Squire; J. Creswell; Luis Cuevas

doi:10.5588/pha.22.0052

Pooling sputum samples for Xpert® MTB/RIF and Xpert® Ultra testing for TB diagnosis

J. S. Bimba
, O. A. Adekeye
, Vibol Iem
, T. T. Eliya
, I. Osagie
, Nadia Kontogianni
, Thomas Edwards
, James Dodd
, Bertie Squire
, J. Creswell
, Luis Cuevas

Research output: Contribution to journal › Article › peer-review

Abstract

Background

The use of molecular amplification as-says for TB diagnosis is limited by their costs and cartridge stocks. Pooling multiple samples to test them together is reported to have similar accuracy to individual testing and to save costs.

Methods

Two surveys of individuals with presumptive TB were conducted to assess the performance of pooled testing using Xpert® MTB/RIF (MTB/RIF) and Xpert® Ultra (Ultra).

Results

A total of 500 individuals were tested using MTB/RIF, with 72 (14.4%) being MTB-positive. The samples were tested in 125 pools, with 50 pools having 1 MTB-positive and 75 only MTB-negative samples: 46/50 (92%, 95% CI 80.8–97.8) MTB-positive pools tested MTB-positive and 71/75 (94.7%, 95% CI 86.9–98.5) MTB-negative pools tested MTB-negative in the pooled test (agreement: 93.6%, κ = 0.867). Five hundred additional samples were tested using Ultra, with 60 (12%) being MTB-positive. Samples were tested in 125 pools, with 42 having 1 MTB-positive and 83 only MTB-negative samples: 35/42 (83.6%, 95% CI 68.6–93.0) MTB-positive pools tested MTB-positive and 82/83 (98.8%, 95% CI 93.5–100.0) MTB-negative pools tested MTB-negative in the pooled test (agreement: 93.6%, κ = 0.851; P > 0.1 between individual and pooled testing). Pooled testing saved 35% (MTB/RIF) and 46% (Ultra) of cartridges.

Conclusions

Pooled and individual testing has a high level of agreement and improves testing efficiency.

Original language	English
Pages (from-to)	Dec-16
Journal	Public Health Action
DOIs	https://doi.org/10.5588/pha.22.0052
Publication status	Published - 21 Mar 2023

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10.5588/pha.22.0052Licence: CC BY

S4Final published version, 86.3 KBLicence: CC BY

Pooling samples to increase testing capacity for Tuberculosis and COVID-19 diagnosis.
Iem, V. (Author), Wingfield, T. (Supervisor), Dominguez, J. (Supervisor) & Khan, J. (Supervisor), 2023
Student thesis: Doctoral thesis

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@article{0d98dd19a66b4cc09e6f1aded29a0480,

title = "Pooling sputum samples for Xpert{\textregistered} MTB/RIF and Xpert{\textregistered} Ultra testing for TB diagnosis",

abstract = "BackgroundThe use of molecular amplification as-says for TB diagnosis is limited by their costs and cartridge stocks. Pooling multiple samples to test them together is reported to have similar accuracy to individual testing and to save costs. MethodsTwo surveys of individuals with presumptive TB were conducted to assess the performance of pooled testing using Xpert{\textregistered} MTB/RIF (MTB/RIF) and Xpert{\textregistered} Ultra (Ultra).ResultsA total of 500 individuals were tested using MTB/RIF, with 72 (14.4\%) being MTB-positive. The samples were tested in 125 pools, with 50 pools having 1 MTB-positive and 75 only MTB-negative samples: 46/50 (92\%, 95\% CI 80.8–97.8) MTB-positive pools tested MTB-positive and 71/75 (94.7\%, 95\% CI 86.9–98.5) MTB-negative pools tested MTB-negative in the pooled test (agreement: 93.6\%, κ = 0.867). Five hundred additional samples were tested using Ultra, with 60 (12\%) being MTB-positive. Samples were tested in 125 pools, with 42 having 1 MTB-positive and 83 only MTB-negative samples: 35/42 (83.6\%, 95\% CI 68.6–93.0) MTB-positive pools tested MTB-positive and 82/83 (98.8\%, 95\% CI 93.5–100.0) MTB-negative pools tested MTB-negative in the pooled test (agreement: 93.6\%, κ = 0.851; P > 0.1 between individual and pooled testing). Pooled testing saved 35\% (MTB/RIF) and 46\% (Ultra) of cartridges.ConclusionsPooled and individual testing has a high level of agreement and improves testing efficiency.",

author = "Bimba, \{J. S.\} and Adekeye, \{O. A.\} and Vibol Iem and Eliya, \{T. T.\} and I. Osagie and Nadia Kontogianni and Thomas Edwards and James Dodd and Bertie Squire and J. Creswell and Luis Cuevas",

year = "2023",

month = mar,

day = "21",

doi = "10.5588/pha.22.0052",

language = "English",

pages = "Dec--16",

journal = "Public Health Action",

issn = "2220-8372",

publisher = "International Union Against Tuberculosis and Lung Disease (The Union)",

}

TY - JOUR

T1 - Pooling sputum samples for Xpert® MTB/RIF and Xpert® Ultra testing for TB diagnosis

AU - Bimba, J. S.

AU - Adekeye, O. A.

AU - Iem, Vibol

AU - Eliya, T. T.

AU - Osagie, I.

AU - Kontogianni, Nadia

AU - Edwards, Thomas

AU - Dodd, James

AU - Squire, Bertie

AU - Creswell, J.

AU - Cuevas, Luis

PY - 2023/3/21

Y1 - 2023/3/21

N2 - BackgroundThe use of molecular amplification as-says for TB diagnosis is limited by their costs and cartridge stocks. Pooling multiple samples to test them together is reported to have similar accuracy to individual testing and to save costs. MethodsTwo surveys of individuals with presumptive TB were conducted to assess the performance of pooled testing using Xpert® MTB/RIF (MTB/RIF) and Xpert® Ultra (Ultra).ResultsA total of 500 individuals were tested using MTB/RIF, with 72 (14.4%) being MTB-positive. The samples were tested in 125 pools, with 50 pools having 1 MTB-positive and 75 only MTB-negative samples: 46/50 (92%, 95% CI 80.8–97.8) MTB-positive pools tested MTB-positive and 71/75 (94.7%, 95% CI 86.9–98.5) MTB-negative pools tested MTB-negative in the pooled test (agreement: 93.6%, κ = 0.867). Five hundred additional samples were tested using Ultra, with 60 (12%) being MTB-positive. Samples were tested in 125 pools, with 42 having 1 MTB-positive and 83 only MTB-negative samples: 35/42 (83.6%, 95% CI 68.6–93.0) MTB-positive pools tested MTB-positive and 82/83 (98.8%, 95% CI 93.5–100.0) MTB-negative pools tested MTB-negative in the pooled test (agreement: 93.6%, κ = 0.851; P > 0.1 between individual and pooled testing). Pooled testing saved 35% (MTB/RIF) and 46% (Ultra) of cartridges.ConclusionsPooled and individual testing has a high level of agreement and improves testing efficiency.

AB - BackgroundThe use of molecular amplification as-says for TB diagnosis is limited by their costs and cartridge stocks. Pooling multiple samples to test them together is reported to have similar accuracy to individual testing and to save costs. MethodsTwo surveys of individuals with presumptive TB were conducted to assess the performance of pooled testing using Xpert® MTB/RIF (MTB/RIF) and Xpert® Ultra (Ultra).ResultsA total of 500 individuals were tested using MTB/RIF, with 72 (14.4%) being MTB-positive. The samples were tested in 125 pools, with 50 pools having 1 MTB-positive and 75 only MTB-negative samples: 46/50 (92%, 95% CI 80.8–97.8) MTB-positive pools tested MTB-positive and 71/75 (94.7%, 95% CI 86.9–98.5) MTB-negative pools tested MTB-negative in the pooled test (agreement: 93.6%, κ = 0.867). Five hundred additional samples were tested using Ultra, with 60 (12%) being MTB-positive. Samples were tested in 125 pools, with 42 having 1 MTB-positive and 83 only MTB-negative samples: 35/42 (83.6%, 95% CI 68.6–93.0) MTB-positive pools tested MTB-positive and 82/83 (98.8%, 95% CI 93.5–100.0) MTB-negative pools tested MTB-negative in the pooled test (agreement: 93.6%, κ = 0.851; P > 0.1 between individual and pooled testing). Pooled testing saved 35% (MTB/RIF) and 46% (Ultra) of cartridges.ConclusionsPooled and individual testing has a high level of agreement and improves testing efficiency.

U2 - 10.5588/pha.22.0052

DO - 10.5588/pha.22.0052

M3 - Article

SN - 2220-8372

SP - Dec-16

JO - Public Health Action

JF - Public Health Action

ER -

Pooling sputum samples for Xpert® MTB/RIF and Xpert® Ultra testing for TB diagnosis

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Student theses

Pooling samples to increase testing capacity for Tuberculosis and COVID-19 diagnosis.

Cite this