GeneXpert for the diagnosis of COVID-19 in LMICs

Rakotosamimanana, Niaina; Randrianirina, Frédérique; Randremanana, Rindra Vatosoa; Raherison, Mamy Serge; Rasolofo, Voahangy; Solofomalala, Gaetan D; Spiegel, André; Heraud, Jean‐Michel

doi:10.1016/s2214-109x(20)30428-9

Cited by 40 publications

(34 citation statements)

References 3 publications

(2 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Since early 2020, healthcare systems in sub-Saharan Africa have had to pivot swiftly to control the COVID-19 epidemic, often leveraging existing diagnostic and surveillance platforms built for TB prevention and control. 12 13 Enormous efforts have been expended on COVID-19 screening and testing, contact tracing, isolation, quarantine and case management. Clinical services and public health infrastructure have been stretched thin trying to respond to the COVID-19 pandemic.…”

Section: Global Health Problem Analysismentioning

confidence: 99%

Fatal SARS-CoV-2 andMycobacterium tuberculosiscoinfection in an infant: insights from Botswana

et al. 2021

View full text Add to dashboard Cite

We report a fatal case of SARS-CoV-2 and Mycobacterium tuberculosis coinfection in an infant, Botswana’s first paediatric COVID-19-associated fatality. The patient, a 3-month-old HIV-unexposed boy, presented with fever and respiratory distress in the setting of failure to thrive. Both the patient and his mother tested positive for rifampin-sensitive M. tuberculosis (Xpert MTB/Rif) and SARS-CoV-2 (real time-PCR). Initially stable on supplemental oxygen and antitubercular therapy, the patient experienced precipitous clinical decline 5 days after presentation and subsequently died. Autopsy identified evidence of disseminated tuberculosis (TB) as well as histopathological findings similar to those described in recent reports of SARS-CoV-2 infections, including diffuse microthrombosis. TB remains a serious public health threat in hyperendemic regions like sub-Saharan Africa, and is often diagnosed late in infants. In addition to raising the question of additive/synergistic pathophysiology and/or immune reconstitution, this case of coinfection also highlights the importance of leveraging the COVID-19 pandemic response to strengthen efforts for TB prevention, screening and detection.

show abstract

Section: Global Health Problem Analysismentioning

confidence: 99%

Fatal SARS-CoV-2 andMycobacterium tuberculosiscoinfection in an infant: insights from Botswana

et al. 2021

View full text Add to dashboard Cite

show abstract

“…These laboratories might have been initially overwhelmed by the volume of tests to be conducted to support pandemic response. Subsequently, the testing capacity has been greatly expanded in several countries, for example by mobilizing GeneXpert machines commonly used to test for tuberculosis (29). Nonetheless, African countries have so far conducted fewer tests per 1,000 people than elsewhere (30).…”

Section: Introductionmentioning

confidence: 99%

Controlling the first wave of the COVID–19 pandemic in Malawi: results from a panel study

Banda

Dube

Brumfield

et al. 2021

Preprint

View full text Add to dashboard Cite

Many African countries have experienced a first wave of the COVID-19 pandemic between June and August of 2020. According to case counts reported daily by epidemiological surveillance systems, infection rates remained low in most countries. This defied early models of the potential impact of COVID-19 on the continent, that projected large outbreaks and massive strain on health systems. Theories proposed to explain the apparently limited spread of the novel coronavirus in most African countries have emphasized 1) early actions by health authorities (e.g., border closures) and 2) biological or environmental determinants of the transmissibility of SARS-CoV-2 (e.g., warm weather, cross-immunity). In this paper, we explored additional factors that might contribute to the low recorded burden of COVID-19 in Malawi, a low-income country in Southeastern Africa. To do so, we used 4 rounds of panel data collected among a sample of adults during the first 6 months of the pandemic in the country. Our analyses of survey data on SARS-CoV-2 testing and COVID-related symptoms indicate that the size of the outbreak that occurred in June-August 2020 might be larger than recorded by surveillance systems that rely on RT-PCR testing. Our data also document the widespread adoption of physical distancing and mask use in response to the outbreak, whereas most measured patterns of social contacts remained stable during the course of the panel study. These findings will help better project, and respond to, future waves of the pandemic in Malawi and similar settings.

show abstract

“…The sensitivity of Xpert Xpress SARS-CoV-2 assays (GeneXpert) was 100% and the specificity was 80% for the diagnosis of COVID-19 in low middle income countries (LMICs) (12). Healthy mother and newborn was discharged home on third postoperative day which corresponds with the length of hospital stay in other studies (3).…”

Section: Discussionmentioning

confidence: 91%