Utility of Xpert MTB/RIF assay for diagnosis of childhood tuberculosisExtrapulmonary and Pulmonary
Journal Title: Journal of Medical Science And clinical Research - Year 2018, Vol 6, Issue 5
Abstract
Background: Xpert MTB/RIF assay is now recommended by WHO for diagnosis of tuberculosis in children but evaluation data is limited. Methods: The study was conducted on 186 consecutive specimens (both respiratory and non respiratory) collected between October 2013 to July 2016 from 171 children having MDR TB or/and clinically suspected tuberculosis. Of the 186 specimens, maximum were sputum 83 (44.6%) followed by gastric aspirate 46 (24.7%), CSF 34 (18.3%), tissue biopsies 8 (4.3%), pleural fluid 6 (3.2%), ascitic fluid 5 (2.6%) and lymph node aspirates 4 (2.2%). Each specimen was subjected to smear examination (direct and after decontamination), culture on Lowenstein Jensen (LJ) medium and Xpert MTB/RIF assay. Results: Analyses on per-sample basis showed that direct smear was positive in 54 (29.2%), culture in 78 (42.2%) and Xpert MTB/RIF assay in 77 (41.6%) specimens. Overall sensitivity and specificity of Xpert MTB/RIF was 93.6% and 96.2% while that of smear was 69.7% and 98.9% respectively against culture as the gold standard. Of the total 77 specimens positive by Xpert MTB/RIF, rifampicin resistance was observed in 7 (9.1%). Conclusion: Xpert MTB/RIF assay is a promising tool for diagnosis as well as detection of rifampicin resistance because of its high sensitivity, specificity and rapidity. However, as more than 50% of clinically suspected children still remain unconfirmed, further refinement of the test before it can replace the current reference standards for diagnosis is to be looked into.
Authors and Affiliations
Dr Shilpa Arora
Keywords
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