The Application of GeneXpert MTB/RIF for Smear-Negative TB Diagnosis as a Fee-Paying Service at a South Asian General Hospital

Shrestha, Poojan; Arjyal, Amit; Caws, Maxine; Prajapati, Krishna; Karkey, Abhilasha; Dongol, Sabina; Pathak, Saruna; Prajapati, Shanti Pradhan; Basnyat, Buddha

doi:10.1155/2015/102430

Cited by 25 publications

(34 citation statements)

References 19 publications

(29 reference statements)

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“…A sample size of 152 SNPT patients were included in the study to be able to have 95% confidence level of estimating percentage of Xpert positivity at 21.3% [9] with relative precision of 30%, participation rate of 85%. The computed sample size was proportionately allocated to Dasmariñas CHO 1 and Trece Martires CHO using 2015 data on number of smear negatives from the two sites.…”

Section: Discussionmentioning

confidence: 99%

Use of GeneXpert and the Role of an Expert Panel in Improving Clinical Diagnosis of Smear-Negative Tuberculosis Cases

Abong¹,

Dalay²,

Langley³

et al. 2019

Preprint

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Setting A high proportion of notified tuberculosis cases in the Philippines are clinically diagnosed (63%) as opposed to bacteriologically confirmed. Better understanding of this phenomenon is required to improve tuberculosis control. Objectives To determine the percentage of Smear Negative Presumptive Tuberculosis patients that would be diagnosed by GeneXpert; compare clinical characteristics of patients diagnosed as tuberculosis cases; and review the impact that the current single government physician and a reconstituted Tuberculosis Diagnostic committee (Expert Panel) may have on tuberculosis over-diagnosis. Design This is a cross-sectional study of 152 patients 15-85 years old with two negative Direct Sputum Smear Microscopy results, with abnormal chest X-ray who underwent GeneXpert testing and review by an Expert Panel. Results 31% (48/152) of the sample were Xpert positive. 93% (97/104) of GeneXpert negatives were clinically diagnosed by a Single Physician. Typical symptoms and X-ray findings were higher in bacteriologically confirmed tuberculosis. When compared to GeneXpert results, the Expert panel’s sensitivity for active tuberculosis was high (97.5%, 39/40) but specificity was low (40.2%, 35/87). Conclusion Using the GeneXpert would increase the level of bacteriologically confirmed tuberculosis substantially among presumptive Tuberculosis. An Expert panel will greatly reduce over-diagnosis usually seen when a decision is made by a Single Physician.

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Section: Discussionmentioning

confidence: 99%

Use of GeneXpert and the Role of an Expert Panel in Improving Clinical Diagnosis of Smear-Negative Tuberculosis Cases

Abong¹,

Dalay²,

Langley³

et al. 2019

Preprint

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“…Sputum smear microscopy for acid fast bacilli remains the most widely used test for PTB [19]. However, this test has a sensitivity of only 50% which is even lower in the setting of human immunodeficiency virus (HIV) infection.…”

Section: Discussionmentioning

confidence: 99%

Haemoptysis in a female with diabetes mellitus: a unique presentation of chronic pulmonary aspergillosis, pulmonary tuberculosis, and Klebsiella peumoniae co‐infection

Ekwueme

Otu

Chinenye

et al. 2016

Clinical Case Reports

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Key Clinical MessageWhile chronic pulmonary aspergillosis (CPA), pulmonary tuberculosis (PTB), and Klebsiella pneumoniae pneumonia co‐infection is rare, we present a 50‐year‐old woman with uncontrolled diabetes who presented with these three diseases. There is considerable overlap in symptoms of PTB and CPA. Treatment with antifungals, anti‐tuberculosis therapy, and antibiotics is beneficial.

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“…Shretha and co-researchers in their report on the application of the technology described AFB smear indicating that 258 patients were smear negative, the gene Xpert tests was able to detect 55 cases from such patient samples. They therefore recommended the inclusion of the tests for free paying patients in low income setting in other to 37 increase the detection rate.…”

Section: Gene X Pert Mtb/rif Assaymentioning

confidence: 99%

Automated diagnosis of Tuberculosis: A review of advancements

Shobowale¹,

Coker²,

Adegunle³

2015

BUMJ

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Objective: A narrative review of advances in automated diagnostic tests for diagnosis of tuberculosis infections. Methods: Electronic databases were searched for tests on automation in Mycobacterium tuberculosis identication. Studies were selected and evaluated that tested for the performance of new and old methods in automated diagnosis with significant impact on the turn-around time of diagnosis and also positive impact on patient care with respect to outcomes. Results: A total of 40 studies were included. Overall, the gene expert system was found to be superior when applied to respiratory samples as opposed to other body fluids when compared to other test methods. High specificity estimates suggest that Nucleic Acid Amplification Tests (NAATS) should be the first-line test for rapid diagnosis of meningitis, but that they also need to be combined with the result of other tests in order to rule out disease. Discussion: Fully automated liquid culture methods overall are superior to mycobacterial culture on solid media, in terms of speed of diagnosis, ease of use and their accuracy with several user friendly systems that can be applied to the Nigerian environment. Conclusion: The DNA amplification tests provide a reliable way of increasing the specificity of diagnosis. Their superior diagnostic capability has been found to hold up in routine clinical practice, and they could confer several advantages on tuberculosis control programs.

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The Application of GeneXpert MTB/RIF for Smear-Negative TB Diagnosis as a Fee-Paying Service at a South Asian General Hospital

Cited by 25 publications

References 19 publications

Use of GeneXpert and the Role of an Expert Panel in Improving Clinical Diagnosis of Smear-Negative Tuberculosis Cases

Use of GeneXpert and the Role of an Expert Panel in Improving Clinical Diagnosis of Smear-Negative Tuberculosis Cases

Haemoptysis in a female with diabetes mellitus: a unique presentation of chronic pulmonary aspergillosis, pulmonary tuberculosis, and Klebsiella peumoniae co‐infection

Automated diagnosis of Tuberculosis: A review of advancements

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