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Title: Clinical validation of urine-based Xpert® MTB/RIF assay for the diagnosis of urogenital tuberculosis: A systematic review and meta-analysis
Authors: Ke Chen
Aijaz Ahmed Malik
Chanin Nantasenamat
Sarfraz Ahmed
Omkar Chaudhary
Changfeng Sun
Yun Juan Sheng
Wen Chen
Wu Gang
Cun Liang Deng
Suvash Chandra Ojha
Affiliated Hospital of Luzhou Medical Colleage
University of Veterinary and Animal Sciences Lahore
Yale School of Medicine
Mahidol University
Keywords: Medicine
Issue Date: 1-Jun-2020
Citation: International Journal of Infectious Diseases. Vol.95, (2020), 15-21
Abstract: © 2020 The Authors Objectives: Effective methods for diagnosing urogenital tuberculosis (UGTB) are important for its clinical management. Therefore, we undertook a systematic review to assess the performance of the urine-based Xpert MTB/RIF assay for UGTB. Methods: PubMed, Embase, Web of Science, the Cochrane library, and Scopus were systematically searched up to July 30, 2019. A hierarchical summary receiver operating characteristic (HSROC) was applied to calculate the pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and odds ratio (OR) for the diagnostic accuracy of the Xpert test. Results: Our search identified 858 unique articles from which 69 studies were selected for full-text revision, with 12 studies meeting the inclusion criteria. Eleven studies comprising 1202 samples compared Xpert with mycobacterial culture, while 924 samples from eight studies compared it with a composite reference standard (CRS). The values for pooled sensitivity, specificity, PLR, NLR, and OR were 0.89, 0.95, 20.1, 0.18, and 159.53, respectively, when compared with the mycobacterial culture. Likewise, when compared with a CRS, the respective pooled sensitivity, specificity, PLR, NLR, and OR values were 0.55, 0.99, 40.67, 0.43, and 166.17, thereby suggesting a high level of accuracy for diagnosing UGTB. A meta-regression and sub-group analysis of TB-burden countries, study design, decontamination, concentration, and reference standard could not explain the heterogeneity (p > 0.05) in the diagnostic efficiency. Conclusions: Our results suggested that Xpert is a promising diagnostic tool for the diagnosis of UGTB via urine specimen.
ISSN: 18783511
Appears in Collections:Scopus 2020

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