{"doi":"10.1093/cid/ciad595","title":"Evidence for Tuberculosis in Individuals With Xpert Ultra “Trace” Sputum During Screening of High-Burden Communities","abstract":"BACKGROUND: \"Trace\" results on Xpert MTB/RIF Ultra (\"Ultra\"; Cepheid) -a molecular diagnostic test for tuberculosis (TB)-are often interpreted as an indication for TB treatment, but may also represent detection of nonviable bacilli or analytical error. In community-screening settings where individual TB risk is low, there is limited guidance on how to interpret Ultra-trace results. METHODS: We conducted systematic Ultra TB screening of adults and adolescents (≥15 years) in Kampala, Uganda, through door-to-door and event-based sputum collection. We enrolled individuals with trace-positive sputum for detailed clinical, radiographic, and microbiological (including 2 sputum cultures, repeat Ultra, and for people with HIV, urine lipoarabinomannan) evaluation, and compared those findings with similar evaluations in controls with Ultra-negative and Ultra-positive (non-trace) sputum. RESULTS: Of 21 957 people screened with Ultra, 211 (1.0%) tested positive, including 96 (46% of positives) with trace results. Of 92 people enrolled with trace-positive sputum; 12% (11/92) were HIV-positive and 14% (13/92) had prior TB. The prevalence of TB among participants with trace-positive sputum results was 14% (13/92) by culture, 24% (22/92) using broader microbiological criteria, and 26% (24/92) after accounting for clinical diagnosis. The prevalence of cough and of abnormal chest computed tomography (CT) findings were 32% and 26%, respectively, if Ultra-negative; 34% and 54% if trace-positive/non-microbiologically confirmed; 72% and 95% if trace-positive/microbiologically confirmed; and 71% and 93% if Ultra-positive (more than trace). CONCLUSIONS: Most individuals with trace-positive sputum in Ugandan communities did not have microbiologically confirmed TB but had more symptoms and chest CT abnormalities than people with Ultra-negative sputum.","journal":"Clinical Infectious Diseases","year":2023,"id":328104,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":24,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.968,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":315614,"name":"Mariam Nantale","orcid":"0000-0001-5696-0703","position":1,"is_corresponding":false},{"id":315463,"name":"Annet Nalutaaya","orcid":"0000-0003-3903-303X","position":2,"is_corresponding":false},{"id":1049428,"name":"Patrick Biché","orcid":"0009-0005-2542-1113","position":3,"is_corresponding":false},{"id":316276,"name":"James Mukiibi","orcid":null,"position":4,"is_corresponding":false},{"id":756519,"name":"Caleb Kamoga","orcid":null,"position":5,"is_corresponding":false},{"id":1050060,"name":"Joab Akampurira","orcid":null,"position":6,"is_corresponding":false},{"id":1050061,"name":"Francis Kayondo","orcid":null,"position":7,"is_corresponding":false},{"id":1050062,"name":"Rogers Kiyonga","orcid":null,"position":8,"is_corresponding":false},{"id":1049429,"name":"Michael Mukiibi","orcid":"0009-0002-0607-2913","position":9,"is_corresponding":false},{"id":316277,"name":"Olga Nakasolya","orcid":null,"position":10,"is_corresponding":false},{"id":1050063,"name":"Molly McGeehan","orcid":null,"position":11,"is_corresponding":false},{"id":315468,"name":"David W. Dowdy","orcid":"0000-0003-0481-7475","position":12,"is_corresponding":false},{"id":315467,"name":"Achilles Katamba","orcid":"0000-0002-2347-4183","position":13,"is_corresponding":false},{"id":315461,"name":"Emily A. Kendall","orcid":"0000-0002-0083-422X","position":14,"is_corresponding":false},{"id":817281,"name":"Joowhan Sung","orcid":"0000-0002-4726-9651","position":0,"is_corresponding":true}],"reference_count":28,"raw_metadata":null,"created_at":"2026-07-19T01:08:52.196069Z","pmid":"37787077","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}