Genexpert Positivity in Sputum Negative Cases with Clinico-radiologically Suggestive of Pulmonary Tuberculosis Infection in Tertiary Center
Keywords:
Pulmonary Tuberculosis, Sputum two sample negative, Gene Xpert positive, Radiologically suggestive Pulmonary TuberculosisAbstract
Background:
Tuberculosis is a major public health problem of word. Nearly 1/3rd of the global population is infected with mycobacterium Tuberculosis. GeneXpert is mainly indicated for early diagnosis and treatment of the pulmonary tuberculosis to prevent the TB related mortality and morbidity.
The objective of this study is to study GeneXpert result in sputum AFB negative but clinic-radiologically suggestive of pulmonary tuberculosis infection.
Methodos:
A Quantitative study was carried in the Department of Internal Medicine of National Medical College. A total of 80 cases with clinically and radiologically suggestive of PTB with AFB negative were included in this study. Data were collected for one year period and calculated the result by using SPSS.
Result:
Among the total 80 patients were included who presented in national medical college Birgunj, Parsa in the time period of 1 year.
In this study most common age group who presented with PTB were 31-45 years in 36.3% case with female predominance in 51.2% cases and male predominance of GeneXpert positive in 31 patients.
Symptoms observed in our study was Cough>2 weeks, hemoptysis, weight loss, fever, SOB and night sweat among which most common presentation was cough >2 weeks in 81.3% cases with GeneXpert predominantly positive in 44 cases presented with cough >2 weeks.
In our study five radiological feature were observed among which most common was pleural effusion in 51 cases, 63.7% cases with predominant GeneXpert positive in 40 cases.
Conclusion:
GeneXpert testing increases the detection of pulmonary tuberculosis cases and it is also use full to diagnose and confirm the pulmonary tuberculosis in smear negative cases.
References
. Tiemersma, E.W., et al., Natural history of tuberculosis: duration and fatality of untreated pulmonary tuberculosis in HIV negative patients: a systematic review. 2011. 6(4): p. e17601.
. Organization, W.H., Ethics guidance for the implementation of the End TB strategy. 2017, World Health Organization.
. Kasper, D., et al., Harrison's principles of internal medicine, 19e. Vol. 1. 2015: Mcgraw-hill New York, NY, USA:.
. Harries, A.D., D. Maher, and P.J.B.o.t.w.H.o. Nunn, An approach to the problems of diagnosing and treating adult smear- negative pulmonary tuberculosis in high-HIV-prevalence settings in sub-Saharan Africa. 1998. 76(6): p. 651.
. Ozkutuk, N. and S.J.M.b. Surucüoglu, Evaluation of the Xpert MTB/RIF assay for the diagnosis of pulmonary and extrapulmonary tuberculosis in an intermediate-prevalence setting. 2014. 48(2): p. 223-232.
. Boehme, C.C., et al., Rapid molecular detection of tuberculosis and rifampin resistance. 2010. 363(11): p. 1005-1015.
. Walusimbi, S., et al., Meta-analysis to compare the accuracy of GeneXpert, MODS and the WHO 2007 algorithm for diagnosis of smear-negative pulmonary tuberculosis. 2013. 13(1): p. 1-13.
. Orina, G.M., et al., Comparative Study of Smear Microscopy, Gene Xpert and Culture and Sensitivity Assays in Detection of Mycobacterium tuberculosis on Sputum Samples among Tuberculosis Suspected Cases in Nyamira County Referral Hospital. 2017.
. Davis, J., C. Ho, and A. Cattamanchi, Availability of an assay for detecting Mycobacterium tuberculosis, including rifampin-resistant strains, and considerations for its use—United States, 2013. 2013.
. Organization, W.H., Tuberculosis surveillance and monitoring in Europe 2019: 2017 data. 2019.
. Behr, M., et al., Transmission of Mycobacterium tuberculosis from patients smear-negative for acid-fast bacilli. 1999. 353(9151): p. 444-449.
. Tostmann, A., et al., Tuberculosis transmission by patients with smear-negative pulmonary tuberculosis in a large cohort in the Netherlands. 2008. 47(9): p. 1135-1142.
. Organization, W.H., Automated real-time nucleic acid amplification technology for rapid and simultaneous detection of tuberculosis and rifampicin resistance: Xpert MTB. 2013, World Health Organization.
. Sedky, M., et al., The role of genexpert in diagnosis of sputum-negative pulmonary tuberculosis. 2018. 67(4): p. 419.
. Ndubuisi, N., et al., Diagnostic accuracy of Xpert MTB/RIF assay in diagnosis of pulmonary tuberculosis. 2016. 2(1): p. 1-4.
. Rai, D.K., et al., Role of gene-xpert in diagnosis of smear negative pulmonary tuberculosis. 2015. 4(105): p. 17034-17038.
. Rajbhandari, B. and N.K.J.N.M.J. Chaudhary, Prevalence of GeneXpert Positive in Sputum Negative with Clinico-radiologically Case Suggestive of Pulmonary Tuberculosis. 2019. 1(2): p. 1-6.
. van Cleeff MR, A., et al., A comprehensive study of the efficiency of the routine pulmonary tuberculosis diagnostic process in Nairobi. 2003. 7(2): p. 186-189.
. Mathur, M., et al., Radiological manifestations of pulmonary tuberculosis-a comparative study between immunocompromised and immunocompetent patients. 2017. 11(9): p. TC06.
Downloads
Published
How to Cite
Issue
Section
License
Authors who submit papers with this journal agree to the following terms.
