TY - JOUR T1 - Xpert MTB/RIF as add-on test to microscopy in a low tuberculosis incidence setting JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.02345-2017 SP - 1702345 AU - Giorgia Sulis AU - Angelica Agliati AU - Gabriele Pinsi AU - Giordano Bozzola AU - Pierfranco Foccoli AU - Maurizio Gulletta AU - Silvio Caligaris AU - Lina R. Tomasoni AU - Issa El-Hamad AU - Alberto Matteelli Y1 - 2018/01/01 UR - http://erj.ersjournals.com/content/early/2018/01/05/13993003.02345-2017.abstract N2 - Tuberculosis (TB) is a major public health concern worldwide. Early diagnosis with universal access to drug-susceptibility testing and prompt initiation of treatment are key elements of the End TB strategy, and should be therefore implemented in all settings [1–5]. In order to reach the TB elimination goals, the World Health Organization (WHO) currently recommends the use of a rapid molecular test, Xpert MTB/Rif (Xpert) (Cepheid, Sunnyvale, CA, USA), as initial diagnostic tool when TB is suspected [6–8]. Although the excellent performance of this test in high TB burden areas is already supported by strong scientific evidence, few studies have been conducted so far to assess its impact on the diagnostic work-up of TB in low-burden settings, sometimes with contrasting findings [7, 9, 10–12]. For example, according to Sohn and coworkers, Xpert testing might have limited impact in the ambulatory setting in Canada due to lower sensitivity and limited potential to expedite diagnosis beyond what is achieved with the existing, well-performing diagnostic algorithm [10].Xpert MTB/Rif should be used as an alternative test for microscopy for TB diagnosis in low-incidence settings.FootnotesThis manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.Conflicts of interest: None to declare ER -