Assessment of geneXpert test for diagnosis of pediatric pulmonary tuberculosis

Authors

  • Km Roma Nepalgunj Medical College and Teaching Hospital https://orcid.org/0009-0002-5017-1687
  • Suvesh Kumar Shrestha University of Ottawa
  • Nirajan Bhandari Nepalgunj Medical College and Teaching Hospital
  • Gaurav Jung Shah Nepalgunj Medical College and Teaching Hospital
  • Shivam Khetan Nepalgunj Medical College and Teaching Hospital

DOI:

https://doi.org/10.3126/bjhs.v8i2.59853

Keywords:

Gene Xpert, Pediatric, Pulmonary tuberculosis, Tuberculosis

Abstract

Introduction: Pediatric tuberculosis is an infectious disease and is a leading cause of death in Nepal. The incidence of pediatric TB is a key tool of ongoing transmission of tuberculosis within the community and vital indicator of disease control. Its diagnosis is very much challenging and delay in diagnosis leads to mortality.

Objectives: This study was conducted to assess the utility of the gene Xpert test for diagnosis of pediatric pulmonary tuberculosis.

Methodology: A hospital based prospective study done at Pediatric department of a teaching hospital, Nepalgunj, Banke conducted over a period of 1 year from 1 January 2021 to 31 December 2021 with presumptive diagnosis of pediatric pulmonary tuberculosis. Chi-square test was used to determine the association between categorical variables and a receiver operating curve (ROC) analysis was performed to compare the performance of gene Xpert test with other lab parameters like sputum/gastric lavage sample microscopy for acid fast bacilli, erythrocytic sedimentation rate, Tuberculin test (TT) and chest X-ray.

 

Results: We enrolled a total of 294 patients in our study. Out of 294 samples 5.1% samples came out to be positive for gene Xpert for MTB. The sputum/gastric lavage samples for AFB showed both sensitivity and specificity of 100%. The tuberculin test showed a sensitivity of 80% and specificity of 37.3%. Chest X-ray showed a sensitivity of 66.7% and specificity of 43.7%. The area under the curve for acid fast bacilli in microscopy, tuberculin test and ESR was found to be 100% (95% CI: 100%-100%), 58.6% (95% CI: 44.9%-72.4%), and 52.6% (95% CI: 37%-68.3%) respectively. 

 

Conclusion: This study highlights the utility of gene Xpert as a good diagnostic tool for rapid diagnosis of pulmonary tuberculosis in pediatric population.

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Author Biographies

Km Roma, Nepalgunj Medical College and Teaching Hospital

Associate Professor, Department of Pediatrics

Suvesh Kumar Shrestha, University of Ottawa

PHD Scholar, Department of Epidemiology

Nirajan Bhandari, Nepalgunj Medical College and Teaching Hospital

Medical Officer, Department of Pediatrics

Gaurav Jung Shah, Nepalgunj Medical College and Teaching Hospital

Lecturer, Department of Community Medicine

Shivam Khetan, Nepalgunj Medical College and Teaching Hospital

Resident, Department of Pediatrics

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Published

2023-11-27

How to Cite

Roma, K., Shrestha, S. K., Bhandari, N., Shah, G. J., & Khetan, S. (2023). Assessment of geneXpert test for diagnosis of pediatric pulmonary tuberculosis. Birat Journal of Health Sciences, 8(2), 2024–2028. https://doi.org/10.3126/bjhs.v8i2.59853

Issue

Section

Original Research Articles