Patient Experiences of Treatment Deferral for Evaluation and Monitoring after a Trace Xpert Ultra Result

Patient Experiences of Treatment Deferral for Evaluation and Monitoring after a Trace Xpert Ultra Result

Publication date: Jan 22, 2025

Background: A “trace” result from the Xpert Ultra molecular TB test indicates Mycobacterium tuberculosis DNA detection but may not always signify TB disease. Little is known about the experiences of individuals with trace results who are not immediately treated. Methods: We enrolled Ugandan adults and adolescents with trace Xpert Ultra sputum results, plus positive and negative controls, from community-screening and clinic settings. After a comprehensive TB evaluation, participants not recommended to start treatment immediately were closely monitored with interval reassessments. Surveys captured participants’ perceptions and preferences related to their uncertain TB status at baseline and during follow-up. Results: A total of 321 people with trace sputum (PWTS), 236 positive controls, and 279 negative controls were enrolled. A minority of PWTS thought they were highly likely to have or develop TB, and most reported low associated anxiety initially (258/321, 80%) and during follow-up. While about half (172/321, 54%) would have favored treatment at baseline if not in the study, those who remained untreated were less inclined toward treatment at six months. Participants generally preferred sensitive diagnostic tests, even with frequent false positives. Conclusions: Deferring treatment for PWTS, with sufficient testing and monitoring, is acceptable to most patients.

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Concepts Keywords
Friends Baseline
Laboratory Enrolled
Tuberculosis Follow
Uganda Negative
Participants
Positive
Preprint
Pwts
Sputum
Test
Testing
Trace
Treatment
Ultra
Xpert

Semantics

Type Source Name
disease MESH anxiety
disease MESH Tuberculosis
pathway KEGG Tuberculosis
disease IDO assay
disease MESH uncertainty
disease MESH emotional distress
disease MESH death
disease IDO symptom
disease IDO process
disease IDO history
disease MESH overtreatment
drug DRUGBANK Isoxaflutole
disease MESH overweight

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