Performance of GeneXpert test in detecting PTB and rifampicin resistance in patients attending Kitui County Hospital

Prominah Kavinya Muia

doi:10.21767/2574-2825-C5-015

Performance of GeneXpert test in detecting PTB and rifampicin resistance in patients attending Kitui County Hospital

9^th Annual Congress on Nursing & Healthcare
December 03-04, 2018 Amsterdam, Netherlands

Prominah Kavinya Muia

Kenya Medical Training College, Kenya

Posters & Accepted Abstracts: J Nurs Health Stud

DOI: 10.21767/2574-2825-C5-015

Abstract

Main Objective: To evaluate the performance of GeneXpert MTB/RIF in detection of pulmonary TB and drug resistant testing. Specific Objectives: To determine the relationship between TB prevalence and the risk factors of gender and age; determine the performance of GeneXpert MTB/RIF; evaluate the effectiveness of the assay in smear positive and smear negative pulmonary specimens and determine the operational feasibility and cost effectiveness of GeneXpert MTB/RIF in routine use. Design: Descriptive cross-sectional study. Setting: Kitui County Hospital. Study subjects: Adult patients of 18 years and above presenting to Kitui County hospital with symptoms suggestive of pulmonary tuberculosis or multi-drug resistant tuberculosis. Main outcome measures: Smear microscopy test method had the highest number of false positives (28%) and false negatives (9.6%). Results: 400 samples were analyzed, 37.5% were smear positive of which 60% (p<0.05) were male. For culture and GeneXpert, the positive samples were 33% and 32.25% respectively. Smear microscopy had the highest number of false positives (28%) and false negatives (9.6%). For bacilli identification, the sensitivity, specificity, positive predictive value and negative predictive values for smear microscopy were 81.8%, 84.3%, 72% and 90.4%; GeneXpert were 97.7%, 100%, 100% and 98.9% respectively. Drug susceptibility testing using culture method showed 23 isolates were rifampicin resistant with GeneXpert, they were 26, implying 3 false positives. The sensitivity, specificity, positive predictive value and negative predictive value for GeneXpert in drug susceptibility testing was 100%, 97%, 89% and 100%. Cost of testing samples with GeneXpert assay was high, but offers rapid detection. Conclusion: GeneXpert MTB/RIF offers high potential for rapid diagnosis of TB and drug susceptibility testing. Recommendation: GeneXpert be considered for routine drug susceptibility testing of TB samples.