Comparison of GeneXpert MTB/RIF assay and LED-FM microscopy for the diagnosis of extra pulmonary tuberculosis in Khyber Pakhtunkhwa, Pakistan

Abstract

GeneXpert is one of the recent technological instruments used to diagnose tuberculosis in a short span of time. In this study, the performance of GeneXpert MTB/RIF assay for the diagnosis of extrapulmonary tuberculosis (EPTB) was compared with light-emitting diode Fluorescent Microscopy (LED-FM) in Khyber Pakhtunkhwa, Pakistan. A total of 737 EPTB samples were collected from tuberculosis (TB) suspected patients. Out of these samples, male to female ratio was 53% (n = 390) to 47% (n = 347) respectively. The sensitivity and specificity was 73% and 100% for GeneXpert, while 40% and 100% for LED-FM microscopy. This shows that the sensitivity of GeneXpert is 40–50%, higher than LED-FM microscopy. GeneXpert also detected low number of bacilli as compared to LED-FM microscopy.

Untitled

“…The school children showed a high percentage of meningitis and lymphadenitis. However, the study showed a close relationship with the study in Beijing children hospital (Wu et al, 2012) The present study showed close relation with the results of Khan et al (Khan et al, 2018), who reported a 40-50% sensitivity of Gne Xpert more than LED-FM microscopy (Abdelwahab et al, 2020). Furthermore, the present study showed agreement with the results where Gene Xpert was a more effective technique in comparison to the ZN technique as detection rate was 62.1% and 41.6% for Gene Xpert and ZN respectively (Chinedum et al, 2017…”

Diagnostic test accuracy of Xpert MTB/RIF for tuberculous pericarditis: a systematic review and meta-analysis

“…Figure 1 showed the flowchart of the research collection, while Table 1 provided a summary of the included studies. Of the nine studies included, three were carried out in Pakistan 10 , 13 , 15 , two were conducted in South Africa 12 , 14 , and the rest were carried out in Turkey 17 , Iran 9 , China 16 , and Spain 11 . All studies used a prospective observational design.…”

“…Regarding the risk of bias in the subject preference area, six studies 9 , 10 , 12 , 14 , 16 , 17 were labeled as low risk, two studies 13 , 15 were labeled as high risk, and one study 11 was labeled as an unclear risk because it did not explain the exclusion criteria clearly. The reason for the high risk of bias in this domain was due to inappropriate exclusion criteria.…”

“…The reason for the high risk of bias in this domain was due to inappropriate exclusion criteria. In the applicability concern section, we labeled one study as a low concern 12 , three studies 10 , 13 , 14 as high concerns, and five studies 9 , 11 , 15 – 17 as unclear concerns since the setting of patients was not mentioned. Studies in primary health settings were deemed low concern, whereas studies set exclusively in a tertiary care center were deemed high concern.…”

Clinical validation of urine-based Xpert® MTB/RIF assay for the diagnosis of urogenital tuberculosis: A systematic review and meta-analysis

“…The number of samples evaluated in each study ranged from 21 to 302, with a median value of 96. Overall, eight (67%) studies were carried out in high-burden TB countries, where the TB prevalence was 63-267 per 100 000 population (Chen et al, 2019;Jing et al, 2017;Khan et al, 2018;Kim et al, 2015;Li et al, 2017;Pang et al, 2017;Samuel et al, 2018;Sharma et al, 2014). Four (33%) studies were conducted in low-burden TB countries, where the TB incidence was 0.81-7.5 per 100 000 population (Habous et al, 2019;Hillemann et al, 2011;Mazzola et al, 2016;Tortoli et al, 2012).…”