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Table 1 Characteristics of studies included in the meta-analysis for rifampicin-resistance tuberculosis detection

From: Xpert MTB/RIF assay for the diagnosis of rifampicin resistance in different regions: a meta-analysis

Study First author [ref.] Year Country Study setting Male (%) HIV (%) Age (year) (Median, IQR) Patient selecting method Total samples n (included n) Specimen type (samples n) Gold standard
1 Al-Ateah SM [15] 2012 Saudi Arabia Laboratory 126 (53.8) 1 (0.4) NR Cross-sectional Unspecified 234 (239) Sputum (56), BAL (116); tissue (16), CSF (14), FNA (5), body fluid (22), abscess (10) DST
2 Antonenka U [16] 2013 German Clinical NR NR NR Retrospective Unspecified 121 (121) Respiratory specimens (121) Solid or liquid media DST
3 Balcells ME [17] 2012 Chile Clinical 127 (79.4) 160 (100) Adults> 18 (37.4, 19–65) Cross-sectional Prospective Consecutive 160 (12) Sputum (160) Solid and liquid media DST
4 Barmankulova A [18] 2015 Kyrgyzstan Laboratory 172 (57.3) NR Median 34, IQR 25–45 Cross-sectional Unspecified 300 (191) Sputum (300) Solid and liquid media DST
5 Barnard M [19] 2012 South Africa Laboratory NR NR NR Unspecified Consecutive 282 (68) Sputum (282) DST
6 Bates M [20] 2013 Zambia Clinical NR 22 (2.4) Children≤15 Prospective Unspecified 930 (930) Sputum, gastric lavage aspirate (930) Liquid culture
7 Biadglegne F [21] 2014 Ethiopia Clinical 99 (42.9) NR 14.7% ≤ 14, 85.3% > 14 Cross-sectional Unspecified 231 (32) Lymph node aspirates (231) DST
8 Blakemore R [22] 2010 America Clinical NR NR NR Unspecified Unspecified 168 (79) Sputum (168) DST
9 Boehme CC [23] 2010   Clinical 929 (53.7) 392 (22.7) Adults≥18 (34, 17–88) Prospective Consecutive 1730 (720) Sputum (1730) Solid media DST
    Peru   181 (53.1) 3 (0.9) Adults≥18 (31, 18–79)   341 (209) Sputum (341) Solid media DST
    Azerbaijan   251 (71.1) 9 (2.6) Adults≥18 (37, 20–69)   353 (143) Sputum (353) Solid or liquid media DST
    South Africa   357 (49.2) 376 (51.8) Adults≥18 (34, 18–74)   726 (183) Sputum (726) Liquid media DST
    India   140 (45.2) 4 (12.9) Adults≥18 (30, 17–88)   310 (185) Sputum (310) Liquid media DST
10 Boehme CC [24] 2011   Clinical 4043 (60.8) 1255 (18.9) Adults≥18 (38, 29–50) Unspecified Consecutive 6648 (1060) Sputum (6648) DST
    Peru   607 (51.2) 5 (0.4) Adults≥18 (37, 26–53)   1185 (185) Sputum (1185) Liquid media DST
    Azerbaijan   748 (99.9) 1 (0.1) Adults≥18 (36, 30–44)   749 (211) Sputum (749) Liquid media DST
    South Africa   1275 (50.6) 947 (37.5) Adults≥18 (36, 29–46)   2522 (188) Sputum (2522) Solid media DST
    Uganda   202 (54.3) 254 (68.3) Adults≥18 (32, 26–38)   372 (116) Sputum (372) Solid media DST
    India   628 (69.6) 40 (4.4) Adults≥18 (45, 32–58)   902 (103) Sputum (902) Solid media DST
    Philippines   583 (63.5) 8 (0.9) Adults≥18 (47, 34–58)   918 (257) Sputum (918) DST
11 Bowles EC [25] 2011 Netherlands Clinical NR NR NR Unspecified Unspecified 89 (60) Sputum (86), pleural fluid (1), gastric fluid (1), bronchial washing (1) DST
12 Carriquiry G [26] 2012 Peru Clinical 95 (73) 131 (100) Adults≥18 (35, 29–42) Cross-sectional Unspecified 131 (39) Sputum (131) Solid and liquid media DST
13 Cayci YT [27] 2017 Turkey Laboratory NR NR NR Unspecified Unspecified 34 (34) Respiratory (19) and Non-respirator specimens (15) Liquid media DST
14 Chakravorty S [28] 2017 South, Africa, India Laboratory NR NR NR Prospective Unspecified 139 (139) Sputum (139) Liquid media DST
15 Chiang TY [29] 2018 China Clinical 876 (29.6) NR Median 55, IQR 35.8–70.0 Prospective Unspecified 2957 (697) Sputum (697) Solid and liquid culture
16 Chikaonda T [30] 2017 Malawi Clinical NR 200 (57.0) Adult≥18 Retrospective Random 351 (188) Sputum (60) Solid and liquid media DST
17 Ciftçi IH [31] 2011 Turkey Clinical NR NR NR Unspecified Unspecified 85 (24) Sputum (50), BAL (25), thorasynthesis fluid (5), urine (5) Liquid media DST
18 Deggim V [32] 2013 Switzerland Clinical NR NR NR Prospective Unspecified 79 (10) Respiratory and Non-respirator specimens (79) DST
19 Dharan NJ [33] 2016 Russia, Peru, Hong Kong, Haiti, USA Clinical 358 (65.8) 536 (98.5) Median 54.2, IQR 19–88 Unspecified, Unspecified 544 (185) Sputum (185) DST
20 Dorman SE [34] 2012 South Africa Laboratory 6469 (93.8) 602 (8.7) Median 43, IQR 34–49 Cross-sectional Consecutive 6893 (144) Sputum (6893) Liquid media DST
21 Dorman SE [35] 2018 South Africa, Uganda, Kenya, India, China, Georgia, Belarus, Brazil Clinical 1059 (60.4) 441 (25.2) Median 38, IQR 28–50 Prospective Unspecified 1753 (551) Sputum (551) Liquid media DST
22 Du J [36 2015 China Clinical 70 (55.6) 5 (4.0) Adults> 16 (38.6, 25.4–51.8) Unspecified Unspecified 126 (126) Pleural biopsy (126), pleural fluid specimens (126) Liquid media DST
23 Feliciano CS [37] 2018 Brazil, Mozambique Clinical 22 (75.9) 6 (20.7) NR Cross-sectional Unspecified 29 (29) NR (29) Solid media DST
24 Giang do C [38] 2015 Vietnam Clinical 98 (65.3) 0 (0) Children< 15 (18.5 months, 5–170 months) Prospective Consecutive 150 (29) Sputum (79), Gastric fluid (215), CSF (3), Pleural fluid (4), Cervical lymphadenopathic pus (1) Liquid media DST
25 Gu Y [39] 2015 China Clinical 28 (46.7) NR Median 39.7, IQR 19.5–74.6 Prospective Unspecified 60 (24) Pus specimens (60) Liquid media DST
26 Guenaoui K [40] 2016 France Laboratory 35 (0.7) NR NR Prospective Unspecified 50 (50) Sputum (50) Liquid DST
27 Helb D [41] 2010 Uganda Clinical 38 (59.3) 20 (31.3) Median 34, IQR 18–60 Retrospective Consecutive 64 (64) Sputum (64) DST
28 Hillemann D [42] 2011 German Laboratory NR NR NR Unspecified Consecutive 521 (29) Urine (91), gastric aspirate (30), tissue (245), pleural fluid (113), CSF (19), stool (23) Liquid media DST
29 Huang H [43] 2018 China Laboratory NR NR NR Retrospective Unspecified 2910 (1066) NR Liquid media DST
30 Huh HJ [44] 2014 South Korea Clinical 197 (65.7) 1 (0.3) Median 58, IQR 18–93 Retrospective Unspecified 300 (98) Sputum (264), Bronchial washing or BAL (39) Solid and liquid media DST
31 Hu P [45] 2014 China Laboratory 1037 (76.7) NR 3.2% < 20, 96.8% ≥ 20 Unspecified Consecutive 1352 (332) Sputum (1352) Solid media DST
32 Jin YH [46] 2017 China Clinical 59 (54.1) NR Median 48.6, IQR 24.0–73.1 Unspecified Unspecified 109 (48) Pus (48) Liquid media DST
33 Kawkitinarong K [47] 2017 Thailand Clinical 284 (58.6) 128 (25.9) Median 41, IQR 30.8–54.3 Prospective Unspecified 521 (228) Pulmonary specimens (228) DST
34 Khalil KF [48] 2015 Pakistan Clinical 36 (38.7) 0 (0) > 16, 19.5–57.6 Unspecified Consecutive 93 (93) BAL (93) Solid media DST
35 Kim CH [49] 2014 South Korea Clinical 104 (60.8) 1 (0.6) Median 58.6, IQR 41.02–76.18 Retrospective Unspecified 171 (26) Pulmonary (160), Non-pulmonary (38) specimens Solid media DST
36 Kim CH [50] 2015 South Korea Clinical 217 (56.7) 1 (0.3) Median 56.31, IQR 38.43–74.18 Retrospective Convenience 383 (444) Sputum (176), Bronchial washes (225), BAL (4); Pleural fluid (36), Tissue (1), Pericardial fluid (1), Lymph node (1) Solid media DST
37 Kim MJ [51] 2015 South Korea Laboratory NR NR NR Unspecified Convenience 52 (45) Sputum (36), bronchial washing (10), pleural fluid (3), pleural mass (1), urine (2) Liquid media DST
38 Kim SY [52] 2012 South Korea Clinical NR NR NR Unspecified Consecutive 71 (62) Sputum (71) Solid and liquid DST
39 Kim YW [53] 2015 South Korea Clinical 761 (53.3) 12 (0.8) Median 59, IQR 0–99 Retrospective Consecutive 1429 (1540) LN and tissue/pus (397), body fluid (469), CSF (254), joint fluid (283), urine (106), others (31) Solid media DST
40 Kim YW [54] 2015 South Korea Clinical 196 (61.1) NR Median 56, IQR 38–71 Retrospective Consecutive 321 (321) Sputum (321) DST
41 Kokuto H [55] 2015 Japan Clinical 51 (54.8) 0 (0) Adult≥20 (59.6, 45.0–75.0) Retrospective Convenience 93 (56) fecal specimens (93) DST
42 Kostera J [56] 2018 Bangladesh Clinical NR NR NR Unspecified Unspecified 132 (122) Sputum (122) Liquid media DST
43 Kurbaniyazova G [57] 2017 Kyrgyzstan Laboratory NR NR Adult≥18 Retrospective Unspecified 2734 (364) (414) NR Solid and liquid media DST
44 Kurbatova EV [58] 2013 Russia Clinical NR NR Adults≥18 Unspecified Consecutive 201 (99) Sputum (201) Solid and liquid media DST
45 Kwak N [59] 2013 South Korea Clinical 426 (62.5) 5 (0.7) Median 61, IQR 47.5–73.0 Retrospective Unspecified 681 (127) Sputum (127) Solid media DST
46 Lawn SD [60] 2011 South Africa Clinical 162 (34.6) 468 (100) Adults≥18 (33.6, 27.8–40.7) Prospective Consecutive 468 (55) Sputum (468) Liquid media DST
47 Lee HY [61] 2013 South Korea Clinical 78 (59.1) 1 (0.8) Median 54.0, IQR 18–90 Retrospective Unspecified 132 (132) Bronchoscopy specimens (132) Ogawa media DST
48 Li Q [62] 2016 China Laboratory NR NR NR Unspecified Consecutive 1973 (449) Sputum (449) Liquid media DST
49 Li Y [63] 2017 China Laboratory 251 (60.6) NR Median 48.5, IQR 38.3–58.7 Unspecified Consecutive 420 (59) Extra-pulmonary specimens (59) Solid media DST
50 Liu X [64] 2015 China Clinical NR NR NR Unspecified Unspecified 134 (44) Pleural biopsy and pleural fluid specimens (100) Liquid media DST
51 Lorent N [65] 2015 Cambodia Clinical 160 (53.5) 189 (64.5) Median 43, IQR 34–52 Prospective Consecutive 299 (102) Sputum (102) Solid media DST
52 Luetkemeyer AF [66] 2016 USA South Africa Brazil Laboratory 446 (45.0) 617 (62.2) Median 46, IQR 35–64 Unspecified Unspecified 992 (194) Sputum (2) DST
53 Metcalfe JZ [67] 2016 Zimbabwe Clinical 216 (61.4) 238 (67.6) Median 36.3, IQR 29.0–44.4 Prospective Consecutive 352 (161) Sputum (161) Solid and liquid media DST
54 Mokaddas E [68] 2015 Kuwait Laboratory NR NR NR Unspecified Unspecified 452 (452) Sputum (287), FNA (66), pus (58), pleural fluid (14), tissue (10), other sterile fluids (8), urine (5), CSF (2), stool (2). Liquid media DST
55 Moon HW [69] 2015 South Korea Clinical NR NR NR Unspecified Unspecified 100 (100) Respiratory specimens (100) DST
56 Moure R [70] 2011 Spain Clinical NR NR NR Retrospective Unspecified 122 (85) Sputum (92), BA (12), pulmonary biopsy (1); pleural fluid (4), gastric aspirate (5), urine (2), stool (1),cerebrospinal fluid (3), ascitic fluid (2), lymph node aspirate (1), skin biopsy (1), mammary abscess (1) DST
57 Mwanza W [71] 2018 Zambia Laboratory NR NR NR Unspecified Consecutive 1070 (24) NR (24) Liquid media DST
58 Myneedu VP [72] 2014 India Laboratory NR NR NR Unspecified Unspecified 134 (88) Sputum (134) Liquid media DST
59 N’guessan K [73] 2014 Cote d’Ivoire Clinical 91 (75.8) NR Median 34.2, IQR 24.1–44.3 Unspecified Unspecified 120 (29) Sputum (120) Liquid media DST
60 N’Guessan K [74] 2018 Côte d’Ivoire Clinical 715 (65.3) 130 (12) Median 33, IQR 18–80 Cross-sectional Consecutive 1095 (162) Sputum (162) Liquid media DST
61 Nikolayevskyy V [75] 2018 Ukraine Clinical 2393 (68.8) 1265 (36.4) Median 38.3, IQR 27–51.6 Retrospective Unspecified 3478 (3167) Pulmonary specimens (3167) Solid and liquid media DST
62 Nicol MP [76] 2011 South Africa Clinical 250 (55.3) 108 (23.9) Children≤15 (19.4 months, 11.1–46.2 months) Prospective Consecutive 452 (77) Sputum (452) DST
63 O’Grady J [77] 2012 Zambia Clinical 446 (50.6) 595 (67.5) Adults> 15 (35, 28–43) Prospective Unspecified 881 (96) Sputum (881) Liquid media DST
64 Ou X [78] 2014 China Laboratory 1741 (70.9) NR NR Unspecified Consecutive 2454 (616) Sputum (2454) Solid media DST
65 Ozkutuk N [79] 2014 Turkey Laboratory NR NR NR Unspecified Unspecified 2639 (133) Sputum (721), BAL (757), gastric fluid (94), endotracheal aspirates (30), transtracheal aspirate (9); urine (341), pleural fluid (232), tissue (176), CSF (111), abscesses (94), peritoneal fluid (42), pericardial fluid (18), joint fluid (7), other (7) Liquid media DST
66 Pan X [80] 2018 China Clinical 120 (63.2) NR Median 46.7, IQR 16–84 Prospective Unspecified 190 (62) Sputum,BAL (62) DST
67 Pang Y [81] 2014 China Clinical 128 NR Children< 14 Prospective Consecutive 211 (10) Gastric lavage aspirates (211) Liquid media DST
68 Park KS [82] 2013 South Korea Clinical NR NR NR Prospective Consecutive 320 (19) Respiratory specimens (320) Liquid media DST
69 Pimkina E [83] 2015 Lithuania Laboratory 559 (70.6) NR Age ≥ 15 Retrospective Unspecified 791 (264) Respiratory specimens (264) Solid or liquid media DST
70 Pinyopornpanish K [84] 2015 Thailand Clinical 34 (59.6) 15 (26.3) ≥15 (55.6, 35.5–75.7) Cross-sectional Consecutive 57 (43) Sputum(57) Liquid media DST
71 Rachow A [85] 2011 Tanzania Clinical 141 (48.3) 172 (58.9) Median 39.2 Unspecified Consecutive 292 (61) Sputum (292) Liquid media DST
72 Rahman A [86] 2016 Bangladesh Clinical NR NR NR Unspecified Unspecified 92 (92) Sputum (92) Liquid media DST
73 Raizada N [87] 2014 India Clinical 2339 (50.8) NR Children< 14 Prospective Consecutive 4600 (48) Sputum (4600) DST
74 Reither K [88] 2015 Tanzania Uganda Clinical 219 (45.6) 197 (43.7) Children< 16 (5.6, 2.0–9.8) Prospective Consecutive 451 (25) Sputum (451) Liquid media DST
75 Rice JP [89] 2017 America Laboratory NR NR Median 50, IQR 35–60 Retrospective Unspecified 637 (120) Sputum (120) Liquid media DST
76 Sharma SK [90] 2015 India Laboratory 909 (64.7) NR Median 37.5, IQR 19.4–55.6 Unspecified Consecutive 1406 (422) Respiratory specimens (422) Solid and liquid media DST
77 Sharma SK [91] 2017 India Laboratory 1405 (55.6) NR Median 35.29, IQR 20–50 Unspecified Convenient 2468 (328) Extra-pulmonary specimens (328) Liquid media DST
78 Singh UB [92] 2016 India Clinical 589 (51.4) NR NR Prospective Unspecified 1145 (72) Pulmonary and Extra-pulmonary specimens (132) Liquid media DST
79 Soeroto AY [93] 2019 Indonesia Clinical 193 (56.9) 5 (1.5) Median 38.2, IQR 25.7–50.7 Retrospective Unspecified 339 (158) NR (158) DST
80 Ssengooba W [94] 2014 Uganda Clinical 155 (36.6) 424 (100) Median 32, IQR 32–34 Prospective Unspecified 424 (9) Sputum (424) Liquid media DST
81 Strydom K [95] 2015 South Africa Laboratory NR NR NR Retrospective Consecutive 120 (115) Sputum (120) Liquid media DST
82 Tahseen S [96] 2016 Pakistan Clinical 1078 (54.3) NR Median 33 Cross-sectional Consecutive 1984 (1533) Sputum (1533) Solid media DST
83 Theron G [97] 2011 South Africa Clinical 325 (67.7) 130 (27.1) Adults≥18 (36, 18–83) Unspecified Consecutive 480 (157) Sputum (480) Liquid media DST
84 Tsuyuguchi K [98] 2017 Japan Clinical 146 (61.6) NR Median 65.2, IQR 23–94 Prospective Consecutive 237 (201) Sputum (201) Solid media DST
85 Ullah I [99] 2017 Pakistan Clinical 130 (48.9) 0 (0) Median 34, IQR 3–80 Unspecified Unspecified 266 (88) Extra-pulmonary specimens (88) DST
86 Vadwai V [100] 2011 India Clinical 251 (45.9) 16 (2.9) Median 37, IQR 8 months-94 Unspecified Consecutive 547 (125) Biopsy (284), pus (147), body fluids (93), CSF (23) Solid and liquid media DST
87 van Kampen SC [101] 2015 Kazakhstan Laboratory NR 52(0.9) NR Prospective Consecutive 5611 (1054) Sputum (5611) Solid or liquid media DST
88 van Kampen SC [102] 2015 Indonesia Clinical 872 (60.5), missing 15(1.0) 35 (2.4) 0.5% < 15, 97.7% ≥ 16, 1.8% missing Unspecified Consecutive 1442 (339) Sputum (1442) DST
89 Wang G [103] 2017 China Clinical NR NR NR Prospective Undefined 1461 (538) Pulmonary specimens (1063), extra-pulmonary specimens (398) Solid media DST
90 Wang G [104] 2019 China Clinical 192 (65.75) 0 (0) Median 42, IQR 14–89 Prospective Consecutive 292 (119) Sputum (90), pleural fluid (29) Solid or liquid media DST
91 Williamson DA [105] 2012 New Zealand Clinical NR NR NR Unspecified Unspecified 169 (14) Respiratory specimens (89); extra-pulmonary specimens (9), MGIT liquid culture vials (71) Liquid media DST
92 Yin QQ [106] 2014 China Clinical 141 (55.3) NR Children≤18 (6.1, 0.3–15.3) Unspecified Unspecified 255 (21) BALF (255) Liquid media DST
93 Yuan M [107] 2016 China Clinical NR 0 (0) NR Retrospective Unspecified 328 (90) Extra-pulmonary specimens (90) DST
94 Zar HJ [108] 2012 South Africa Clinical 294 (55.0) 117 (21.9) Children< 15 (19.0 months, 11.2–38.3 months) Unspecified Consecutive 535 (125) Nasopharyngeal specimens, sputum (535) Liquid culture
95 Zar HJ [109] 2014 South Africa Clinical 181 (47) 31 (8) Children< 15 (38.3 months, 21.2–56.5 months) Prospective Consecutive 384 (18) Sputum (309), Nasopharyngeal aspirate specimens (309) DST
96 Zetola NM [110] 2014 Botswana Clinical 221 (59.7) 279 (59.4) Adult≥18 (37, 31–44) Retrospective Consecutive 370 (370) Sputum (370) DST
97 Zhang AM [111] 2016 China Clinical 65 (59.6) 0 (0) Children≤14 Unspecified Unspecified 109 (21) Pulmonary and Extra-pulmonary specimens (21) Liquid media DST
  1. Sample selection: Study units selected prospectively, or retrospectively from existing samples; Consecutive, random or convenience sampling method. ‘Unspecified’ refers to studies where there was no clear indication how the study participants were chosen. Solid media culture(Löwensten-Jensen), liquid media culture (Bactec MGIT 960)