EVALUATION OF GENE XPERT ASSAY IN EXTRAPULMONARY TUBERCULOSIS IN CHILDREN
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2019, Vol 8, Issue 1
Abstract
BACKGROUND Tuberculosis constitutes the main infectious cause of death worldwide. Extra-pulmonary tuberculosis (EPTB) accounts for up to sixty percent of all cases of childhood tuberculosis. In high burden countries like India, WHO in December 2010 endorsed a new rapid test “Gene Xpert MTB/RIF” as a replacement of sputum smear microscopy particularly in smear negative and multidrug resistant TB. We aimed to assess the performance of the Xpert system in diagnosing EPTB in children in a high incidence settings like India and conducted the present study at a tertiary care teaching hospital in New Delhi, India. MATERIALS AND METHODS This is a cross-sectional, hospital-based study. We investigated 60 extrapulmonary clinical specimens with Gene Xpert including 27 (45%) cases of tubercular meningitis, 17 (28%) cases of pleural tuberculosis, 12 (20%) cases of tubercular lymphadenitis, 3 (5%) cases of abdominal Koch’s and one (2%) case of pericardial tuberculosis and determined the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of CBNAAT and compared the efficacy of CBNAAT in the rate of detection of Mycobacteria, with the gold standard i.e. Culture (MGIT liquid culture). RESULTS The overall sensitivity of Xpert MTB/RIF was between 50 to 90 percent in various tissue samples while specificity in all samples was approaching almost 100 percent with maximum efficacy in tubercular lymphadenitis where the sensitivity was 90 percent followed by tubercular meningitis with 80 percent sensitivity. CONCLUSION Xpert MTB/RIF was found to be superior in detecting Mycobacterium tuberculosis in Extrapulmonary TB samples with respect to time of result and Rifampicin resistance detection. At present, CBNAAT is being used as a routine test in a suspected Extrapulmonary TB case at our center.
Authors and Affiliations
Jitendra Singh Rathour, Mukta Mantan, Ashwani Khanna, Mohammed Hanif
EFFECT OF TOBACCO ON ORAL-HEALTH AN OVERVIEW
Tobacco is the greatest disease-producing product, with its prevalent addictive habit influencing the behavior of human beings for more than four centuries. Tobacco is consumed orally in a variety of forms such...
ANTIBIOGRAM OF ENTEROCOCCAL SPECIES ISOLATED FROM CLINICAL SPECIMENS IN A TERTIARY CARE TEACHING HOSPITAL
BACKGROUND Enterococci are Gram-positive cocci that are normal inhabitants of the gastrointestinal tract. Enterococci have become the second most common agent recovered from nosocomial UTI and wound infections a...
PLASMA CELL LEUKAEMIA- AN AGGRESSIVE PLASMA CELL DYSCRASIA
Plasma cell leukaemia is a rare and aggressive variant of plasma cell myeloma having poor outcome. Some improvements in outcome have been made in recent years with newer therapies and stem cell transplantation. Plasma ce...
RENAL RESISTIVE INDEX AS A PREDICTOR OF ACUTE HYDRONEPHROSIS IN PATIENTS WITH RENAL COLIC
BACKGROUND Urolithiasis remains a major health problem worldwide. Patients with renal colic are 33% to 68.3% at risk of acute urinary obstruction (partial or complete) leading to hydroureteronephrosis. Our study was done...
CLINICO-EPIDEMIOLOGICAL PROFILE OF ACUTE WATERY DIARRHOEA IN UNDER FIVE CHILDREN WITH SPECIAL REFERENCE TO ROTAVIRUS INFECTION
BACKGROUND Diarrhoeal disorders in childhood accounts for a large proportion (9%) of childhood deaths with an estimated 0.71 million deaths per year globally, making it the second most common cause of child deaths worldw...