Dereje Habte1, Muluken Melese2, Nebiyu Hiruy2, Zewdu Gashu2, Degu Jerene2, Feleke Moges3, Sisay Yifru4, Belaineh Girma5, Yewulsew Kassie6, Yared Kebede Haile6, Pedro Guillermo Suarez7, Belay Tessema3. 1. Management Sciences for Health, Help Ethiopia Address the Low Performance of Tuberculosis (HEAL TB) Project, Addis Ababa, Ethiopia. Electronic address: dhabte@msh.org. 2. Management Sciences for Health, Help Ethiopia Address the Low Performance of Tuberculosis (HEAL TB) Project, Addis Ababa, Ethiopia. 3. Department of Medical Microbiology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia. 4. Department of Pediatrics, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia. 5. Monitoring and Evaluation Unit, National Tuberculosis Program, Lilongwe, Malawi. 6. United States Agency for International Development (USAID), Addis Ababa, Ethiopia. 7. Management Sciences for Health, Health Programs Group, Arlington, Virginia, USA.
Abstract
OBJECTIVE: The objective of this study was to compare the diagnostic yield of GeneXpert MTB/RIF with Ziehl-Neelson (ZN) sputum smear microscopy among index TB cases and their household contacts. METHODS: A cross sectional study was conducted among sputum smear positive index TB cases and their household contacts in Northern Ethiopia. RESULTS: Of 353 contacts screened, 41 (11%) were found to have presumptive TB. GeneXpert test done among 39 presumptive TB cases diagnosed 14 (35.9%) cases of TB (one being rifampicin resistant), whereas the number of TB cases diagnosed by microscopy was only 5 (12.8%): a 64.3% increased positivity rate by GeneXpert versus ZN microscopy. The number needed to screen and number needed to test to diagnose a single case of TB was significantly lower with the use of GeneXpert than ZN microscopy. Of 119 index TB cases, GeneXpert test revealed that 106 (89.1%) and 5 (4.2%) were positive for rifampicin sensitive and rifampicin resistant TB, respectively. CONCLUSION: GeneXpert test led to increased TB case detection among household contacts in addition to its advantage in the diagnosis of Rifampicin resistance among contacts and index TB cases. There should be a consideration in using GeneXpert MTB/RIF as a point of care TB testing tool among high risk groups.
OBJECTIVE: The objective of this study was to compare the diagnostic yield of GeneXpert MTB/RIF with Ziehl-Neelson (ZN) sputum smear microscopy among index TB cases and their household contacts. METHODS: A cross sectional study was conducted among sputum smear positive index TB cases and their household contacts in Northern Ethiopia. RESULTS: Of 353 contacts screened, 41 (11%) were found to have presumptive TB. GeneXpert test done among 39 presumptive TB cases diagnosed 14 (35.9%) cases of TB (one being rifampicin resistant), whereas the number of TB cases diagnosed by microscopy was only 5 (12.8%): a 64.3% increased positivity rate by GeneXpert versus ZN microscopy. The number needed to screen and number needed to test to diagnose a single case of TB was significantly lower with the use of GeneXpert than ZN microscopy. Of 119 index TB cases, GeneXpert test revealed that 106 (89.1%) and 5 (4.2%) were positive for rifampicin sensitive and rifampicin resistant TB, respectively. CONCLUSION: GeneXpert test led to increased TB case detection among household contacts in addition to its advantage in the diagnosis of Rifampicin resistance among contacts and index TB cases. There should be a consideration in using GeneXpert MTB/RIF as a point of care TB testing tool among high risk groups.
Authors: Adrienne E Shapiro; Jennifer M Ross; Mandy Yao; Ian Schiller; Mikashmi Kohli; Nandini Dendukuri; Karen R Steingart; David J Horne Journal: Cochrane Database Syst Rev Date: 2021-03-23