TY - JOUR
T1 - Face mask sampling (FMS) for tuberculosis shows lower diagnostic sensitivity than sputum sampling in Guinea
AU - Hassane-Harouna, Souleymane
AU - Braet, Sofie Marijke
AU - Decroo, Tom
AU - Camara, Lansana Mady
AU - Delamou, Alexandre
AU - Bock, Sven de
AU - Ortuño-Gutiérrez, Nimer
AU - Cherif, Gba-Foromo
AU - Williams, Caroline M
AU - Wisniewska, Anika
AU - Barer, Michael R
AU - Rigouts, Leen
AU - de Jong, Bouke Catherine
N1 - FTX; DOAJ; (CC BY)
PY - 2023
Y1 - 2023
N2 - BACKGROUND: Pulmonary tuberculosis (PTB) diagnosis relies on sputum examination, a challenge in sputum-scarce patients. Alternative non-invasive sampling methods such as face mask sampling (FMS) have been proposed.OBJECTIVE: To evaluate the value of FMS for PTB diagnosis by assessing its agreement with sputum samples processed by GeneXpert MTB/RIF (Ultra)(Xpert) testing, and describe FMS sensitivity and specificity.METHODS: This was a prospective study conducted at the Carrière TB clinic in Guinea. Presumptive TB patients willing to participate were asked to wear a surgical mask containing a polyvinyl alcohol (PVA) strip for thirty minutes. Subsequently, two spot sputum samples were collected, of which one was processed by microscopy on site and the other by Xpert in Guinea's National Reference Laboratory of Mycobacteriology (LNRM). The first 30 FMS were processed at the Supranational Reference Laboratory in Antwerp, Belgium, and the following 118 FMS in the LNRM.RESULTS: One hundred fifty patients participated, of whom 148 had valid results for both mask and sputum. Sputum smear microscopy was positive for 47 (31.8%) patients while sputum-Xpert detected MTB in 54 (36.5%) patients. Among the 54 patients testing sputum-Xpert positive, 26 (48.1%) yielded a positive FMS-Xpert result, while four sputum-Xpert negative patients tested positive for FMS and 90 patients were Xpert-negative for both sputum and mask samples, suggesting a moderate level of agreement (k-value of 0.47). The overall mask sensitivity was 48.1%, with 95.7% specificity.CONCLUSION: In our setting, Xpert testing on FMS did not yield a high level of agreement to sputum sample.
AB - BACKGROUND: Pulmonary tuberculosis (PTB) diagnosis relies on sputum examination, a challenge in sputum-scarce patients. Alternative non-invasive sampling methods such as face mask sampling (FMS) have been proposed.OBJECTIVE: To evaluate the value of FMS for PTB diagnosis by assessing its agreement with sputum samples processed by GeneXpert MTB/RIF (Ultra)(Xpert) testing, and describe FMS sensitivity and specificity.METHODS: This was a prospective study conducted at the Carrière TB clinic in Guinea. Presumptive TB patients willing to participate were asked to wear a surgical mask containing a polyvinyl alcohol (PVA) strip for thirty minutes. Subsequently, two spot sputum samples were collected, of which one was processed by microscopy on site and the other by Xpert in Guinea's National Reference Laboratory of Mycobacteriology (LNRM). The first 30 FMS were processed at the Supranational Reference Laboratory in Antwerp, Belgium, and the following 118 FMS in the LNRM.RESULTS: One hundred fifty patients participated, of whom 148 had valid results for both mask and sputum. Sputum smear microscopy was positive for 47 (31.8%) patients while sputum-Xpert detected MTB in 54 (36.5%) patients. Among the 54 patients testing sputum-Xpert positive, 26 (48.1%) yielded a positive FMS-Xpert result, while four sputum-Xpert negative patients tested positive for FMS and 90 patients were Xpert-negative for both sputum and mask samples, suggesting a moderate level of agreement (k-value of 0.47). The overall mask sensitivity was 48.1%, with 95.7% specificity.CONCLUSION: In our setting, Xpert testing on FMS did not yield a high level of agreement to sputum sample.
KW - Humans
KW - Sputum
KW - Guinea
KW - Masks
KW - Prospective Studies
KW - Tuberculosis
KW - Tuberculosis, Pulmonary/diagnosis
U2 - 10.1186/s12941-023-00633-8
DO - 10.1186/s12941-023-00633-8
M3 - A1: Web of Science-article
C2 - 37679838
SN - 1476-0711
VL - 22
JO - Annals of Clinical Microbiology and Antimicrobials
JF - Annals of Clinical Microbiology and Antimicrobials
IS - 1
M1 - 81
ER -