An assessment of nucleic acid amplification testing for active mycobacterial infection


Subquestions (for a linked evidence approach)



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Subquestions (for a linked evidence approach):


Accuracy

  • What is the accuracy of NAAT in the diagnosis of patients with suspected MTB, compared with AFB microscopy and culture?

  • What is the accuracy of NAAT plus AFB microscopy in the diagnosis of patients with suspected MTB, compared with AFB microscopy alone?

  • What is the accuracy of in-house NAAT compared with commercial NAAT in the diagnosis of patients with suspected MTB, using culture as the reference standard?

  • What is the accuracy of NAAT in the detection of genetic mutations on the rpoB gene that are associated with rifampicin resistance?

  • What is the accuracy of NAAT in the diagnosis of NTM in patients suspected of having an NTM infection, compared with culture?

Change in management

  • Does AFB microscopy plus NAAT to determine the presence of MTB and rifampicin resistance change patient management, compared with management decisions made based on AFB microscopy alone, in patients with a high pre-test probability of active TB?

  • Does AFB microscopy plus NAAT to determine the presence of MTB and rifampicin resistance change patient management, compared with management decisions made based on AFB microscopy alone, in patients with a low-pre-test probability of TB?

  • Does NAAT plus culture change patient management, compared with culture plus other tests, in patients suspected of having an NTM infection?

Effectiveness of change in management

  • To what extent does treating patients who have rifampicin-resistant MTB infections with alternative treatments result in better health outcomes for the patient and their contacts?

  • What is the health impact of early versus delayed treatment of TB on the individual and their contacts?

  • What adverse events (AEs) are associated with inappropriate antibiotic treatment for TB?

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