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IJSTR >> Volume 7 - Issue 2, February 2018 Edition



International Journal of Scientific & Technology Research  
International Journal of Scientific & Technology Research

Website: http://www.ijstr.org

ISSN 2277-8616



Xpert Mtb / Rif Assay For Rapid Diagnosis Of Pulmonary Tuberculosis In Primary Health Care Services

[Full Text]

 

AUTHOR(S)

Zarnadze M . Tkhelidze M. Kerkadze V. Khetsuriani Sh. Wameedh Alshahwani

 

KEYWORDS

tuberculosis, M. tuberculosis, XpertMTB/Rif assay, smear microscopy, primary health care services. laboratory diagnostic of TB.

 

ABSTRACT

The aim of this study was to show on the example of the one peripherial laboratory, next to the sputum smear microscopy, importance of implementation new simple, rapid and more sensitive diagnostic method as Xpert MTB/Rif test, which also can detect the drug resistance. There were retrospectively reviewed the results of direct sputum smear microscopy and XpertMTB/Rif test of 1276 patient, with suspected pulmonary TB, which were performed from April of 2015 until May of 2016 in the laboratory of Central Correctional Hospital of Minister of Corrections and Legal Assistance of Georgia. From 1276 patients, XpertMTB/Rif test has detected in 52 cases M. tuberculosis in sputum sample (MTB positive patients). From these 52 cases in 25 (48.0±6.92%) patient it was Rif/ Sensitive, in 23 (44.23±6.88%) Rif/ Resistant MTB. In 4 (7.69±3.69%) patients the test cannot determine the sensitivity to rifampicin. From these 52 Xpert/ MTB positive cases, only 17 (32.7±7.21%)%) were smear positive, other 35 (67.30±6.50%)%) - were smear negative. So without the XpertMTB/Rif test, in the laboratory of Central Correctional Hospital of Minister of Corrections and Legal Assistance of Georgia (primary health care service laboratory), it would be able to suspect TB only in 32.7±7.21% cases (smear positive patients) and in the same time we would not know the sensitivity to drug, which is so important for the adequate treatment. In 67.30±6.50% smear negative cases of patients without the XpertMTB/Rif test we even would not suspect laboratory positivity to TB. In these cases the laboratory diagnosis of TB would be given after sending the sputum sample in the Reference laboratory. It would need several weeks for the final results and would be the reason of delay in the beginning of the appropriate treatment and would be great chance of further spread of disease.

 

REFERENCES

[1] “Policy statement: Automated real-time nucleic acid amplification technology for rapid and simultaneous detection of tuberculosis and rifampicin resistance: Xpert MTB/RIF system”, WHO, Geneva, 2011 www.who.int/tb/features_archive/xpert_rapid_tb_test/ - See more at: http://www.tbfacts.org/xpert-tb-test/#sthash.Q65Eartc.dpuf

[2] Handbook on TB laboratory diagnostic methods for the European Union. European Centre for Disease Prevention and Control. Stockholm: ECDC; 2016. 105p.

[3] Implementing tuberculosis diagnostics: A policy framework , 2014 http://www.who.int/tb/publications/implementing_TB_diagnostics/en/.
[4] Desikan P. Sputum smear microscopy in tuberculosis: Is it still relevant? Indian J Med Res. 2013 Mar; 137(3): 442–444.

[5] World Health Organization. Global tuberculosis report 2015. (2015) Reviewed March 2016 http://www.who.int/mediacentre/factsheets/fs104/en/

[6] Drug resistant tuberculosis. WHO. 2015 http://www.who.int/tb/areas-of-work/drug-resistant-tb/en/
[7] Xpert MTB/RIF assay for the diagnosis of pulmonary and extrapulmonary TB in adults and children.World Health Organization http://www.who.int/tb/publications/xpert-mtb-rif-assay-diagnosis-policy-update/en/ 2013 p.