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Abstract
Background
Early detection and treatment of tuberculosis (TB) are of great importance to stop its spread. However, optimising the active case findingstrategy is critical to improving its feasibility in regions where TB is epidemic.
Method
The different pooled ratios between TB-positive and TB-negative sputum specimens were evaluated and a pooling ratio of 5:1 was used for the active case finding screening by Xpert MTB/RIF Ultra among high-risk groups in Beijing.
Results
The sensitivity of pooling ratio at 5:1 was 97.5% (39/40). Between October 2022 and March 2023, among 17,681 participants, 1729 metthe active case finding criteria and were screened by 350 5:1 sputum pools by Xpert MTB/RIF Ultra. Four pools (1.1%) tested positive and were further confirmed as definite active TB cases. In our study population with high TB incidence (231/100,000), the cost for detection of individual patients was reduced by 77.4% at a 5:1 pooling ratio.
Conclusions
pooled sputum testing at a suitable ratio using Xpert MTB/RIF Ultra provides a rapid, efficient, and cost-effective method for active TB case finding among high-risk groups in a low-incidence area.
Author contributions
ZM reviewed patient journals and performed data collection together with LZ, SL and YS. YW and ZX performed statistical analysis, and WS, YL, JG and DG performed data interpretation. XG, DG, ZM and YWT performed experiments in this study. All authors discussed the results, implications and commented on the manuscript at all stages. LL and YP have planned the study and done most of the writing
Disclosure statement
XG, DG, and YWT are employees of Cepheid, the commercial manufacturer of the Xpert MTB/RIF Ultra. The other authors declare no conflict of interest. Restauthors declare no competing interests.