International Journal of Medical Laboratory Research (IJMLR)

EVALUATION OF GENEXPERT FOR THE DIAGNOSIS OF HIV ASSOCIATED TB AND RIFAMPICIN RESISTANCE IN GUYANA

​

*Rajini Kurup, Candacy Clarke, Odessa Trim

​

ABSTRACT: BACKGROUND: In countries like Guyana, where there is a heavy Tuberculosis (TB) burden, delays in the diagnosis of TB can have a detrimental outcome. This concern has led to invention and evaluation of different approaches to TB laboratory diagnosis. In this study, we compared the performance of light-emitting diode (LED) fluorescent microscopy (FM) and GeneXpert for the diagnosis of tuberculosis. METHODS: A retrospective study was conducted between September 2014 and July 2016. Data was extracted from the National Public Health Reference Laboratory Log books. RESULTS: A total of 568 patients were included based on their test results containing data on GeneXpert and LED FM. This study found that GeneXpert and LED FM was able to detect MTB in 162 (29%) and 76 (13%) cases respectively. The detection rate among HIV infected patient was higher with 69% for GeneXpert and 28% for LED FM. The Rifampicin resistance was found 14.2% in PTB patients. CONCLUSION: It can be concluded from this research that the detection rate of GeneXpert is much higher than that of the LED FM when testing for Tuberculosis. Thus, the implementation of GeneXpert can dramatically improve the diagnosis of tuberculosis and ultimately patient outcome.

KEY WORDS: AIDS, LED FM, Rifampicin

​

REFERENCES

1. WHO (2018). TB fact sheet. World Health Organization.http://www.who.int/mediacentre/factsheets/fs104/en/

2. Tuberculosis. WHO Global Tuberculosis Report 2014.http://www.who.int/tb/publications/global_report/gtbr14_executive_summary.pdf

3. WHO (2010). WHO endorses new rapid tuberculosis test.

4. Kurup R, Serieux L, Josiah D, Scaria G. Efficacy of fluorescence microscopy in the diagnosis of tuberculosis in Guyana. Int J Trop Dis & Health. 2014; 8(4):165–169.

5. WHO. (2009). Approaches to improve sputum smear microscopy for tuberculosis diagnosis

6. Lawn SD, Wood R. Tuberculosis in antiretroviral treatment services in resource-limited settings: addressing the challenges of screening and diagnosis. J Infect Dis 2011. In press

7. Ukaegbu C, Ani A, Nnachi A. Molecular detection of Mycobacterium tuberculosis complex by GenoType®MTBDRplus from patients attending Bingham university teaching hospital, Jos, Nigeria.  2016; 9(6), 1–11.

8. Alkins W (2000). TB in Guyana. Retrieved September 18, 2016, from http://guyana.deonandan.com/TB.htm

9. WHO (2011). Fluorescent Light-Emitting Diode (LED) Microscopy for Diagnosis of Tuberculosis: Policy Statement. 

10. Seni J, Kidenya BR, Anga M, Kapesa A, Meda JR, Mshana SE. Incremental detection of pulmonary tuberculosis among presumptive patients by GeneXpert MTB/RIF® over fluorescent microscopy in Mwanza, Tanzania: An operational study. Healthcare in Low-resource Settings. 2015; 3(1).

11. Theron G, Zijenah L, Chanda D. Feasibility, accuracy, and clinical effect of point-of-care Xpert MTB/RIF testing for tuberculosis in primary-care settings in Africa: a multicentre, randomised, controlled trial. Lancet 2014;383:424-35

12. Al-Darraji HAA, Razak HA, Ng KP, Altice FL, Kamarulzaman A. The diagnostic performance of a single GeneXpert MTB/RIF assay in an intensified tuberculosis case finding survey among HIV-Infected prisoners in Malaysia. 2013;8(9)

13. Steingart KR, Schiller I, Horne DJ. Xpert® MTB/RIF assay for pulmonary tuberculosis and rifampicin resistance in adults. Cochrane Database of Systematic Reviews 2014; 1:CD009593.