Diagnostic performance of GeneXpert in tuberculosis-HIV co-infected patients at Asella Teaching and Referral Hospital, Southeastern Ethiopia: A cross sectional study.
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2021
2021
Historique:
received:
28
02
2020
accepted:
28
10
2020
entrez:
27
1
2021
pubmed:
28
1
2021
medline:
21
4
2021
Statut:
epublish
Résumé
GeneXpert is a new introduction in the diagnostic modality to fight tuberculosis (TB) among people living with HIV (PLHIV) under the program of intensified TB case finding. This study aimed to evaluate the diagnostic performance of GeneXpert under the program of intensified TB cases finding among PLHIV. Cross-sectional study was conducted by recruiting individuals attending an HIV clinic from February 2018 to January 2019. Data on clinical parameters were collected using a standardized tool. Two-morning sputum samples were collected and processed for smear microscopy and GeneXpert. SPSS 21 used for data analysis. Proportion, percentage, and mean with SD were used to describe variables. Univariate and multivariable logistic regressions were used to assess factors associated with the GeneXpert. Values for which the 95% CI interval not includes 1 and for which P<0.05 were considered significant. A total of 384 presumptive TB-HIV co-infection cases were included, of which 166 (43%) were diagnosed to have TB. Fifty-four (32.5%) TB cases were smear AFB positive while 79 (47.7%) TB cases were GeneXpert positive. The GeneXpert detection rate was almost two-fold of that of smear microscopy and all smear positive TB cases were detected by GeneXpert. Moreover, GeneXpert was able to detect an additional third of TB confirmed cases among smear AFB negative cases. Advanced stage of the disease, high viral load and presence of anemia were significantly associated with TB. The WHO TB screening tool remained least sensitive with the lowest positive predictive value. GeneXpert demonstrated two-fold case detection rate compared to the sputum smear microscopy and additional third TB case detection rate among smear AFB negative cases. Clinical screening tool for evaluation of TB-HIV co-infection showed poor performance in TB case notification.
Sections du résumé
BACKGROUND
GeneXpert is a new introduction in the diagnostic modality to fight tuberculosis (TB) among people living with HIV (PLHIV) under the program of intensified TB case finding. This study aimed to evaluate the diagnostic performance of GeneXpert under the program of intensified TB cases finding among PLHIV.
METHODS
Cross-sectional study was conducted by recruiting individuals attending an HIV clinic from February 2018 to January 2019. Data on clinical parameters were collected using a standardized tool. Two-morning sputum samples were collected and processed for smear microscopy and GeneXpert. SPSS 21 used for data analysis. Proportion, percentage, and mean with SD were used to describe variables. Univariate and multivariable logistic regressions were used to assess factors associated with the GeneXpert. Values for which the 95% CI interval not includes 1 and for which P<0.05 were considered significant.
RESULT
A total of 384 presumptive TB-HIV co-infection cases were included, of which 166 (43%) were diagnosed to have TB. Fifty-four (32.5%) TB cases were smear AFB positive while 79 (47.7%) TB cases were GeneXpert positive. The GeneXpert detection rate was almost two-fold of that of smear microscopy and all smear positive TB cases were detected by GeneXpert. Moreover, GeneXpert was able to detect an additional third of TB confirmed cases among smear AFB negative cases. Advanced stage of the disease, high viral load and presence of anemia were significantly associated with TB. The WHO TB screening tool remained least sensitive with the lowest positive predictive value.
CONCLUSION
GeneXpert demonstrated two-fold case detection rate compared to the sputum smear microscopy and additional third TB case detection rate among smear AFB negative cases. Clinical screening tool for evaluation of TB-HIV co-infection showed poor performance in TB case notification.
Identifiants
pubmed: 33503051
doi: 10.1371/journal.pone.0242205
pii: PONE-D-20-05777
pmc: PMC7840185
doi:
Types de publication
Clinical Trial
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0242205Déclaration de conflit d'intérêts
No authors have competing interests.
Références
PLoS Med. 2011 Jul;8(7):e1001064
pubmed: 21814497
J Clin Tuberc Other Mycobact Dis. 2018 Jun 14;12:14-20
pubmed: 31720393
PLoS One. 2018 Oct 3;13(10):e0203986
pubmed: 30281631
Tuberc Res Treat. 2015;2015:571782
pubmed: 26064681
BMC Infect Dis. 2019 Aug 13;19(1):714
pubmed: 31409289
PLoS One. 2017 Jan 12;12(1):e0169798
pubmed: 28081227
Lancet. 2011 Apr 30;377(9776):1495-505
pubmed: 21507477
Am J Respir Crit Care Med. 2014 Jun 15;189(12):1551-9
pubmed: 24869625
BMC Pulm Med. 2017 May 30;17(1):87
pubmed: 28558662
Cochrane Database Syst Rev. 2014 Jan 21;(1):CD009593
pubmed: 24448973
Int J Immunopathol Pharmacol. 2019 Jan-Dec;33:2058738419827174
pubmed: 30791749
BMC Infect Dis. 2014 Dec 31;14:709
pubmed: 25599808
Can J Infect Dis Med Microbiol. 2018 Jul 4;2018:1346104
pubmed: 30073038
AIDS. 1999 Mar 11;13(4):501-7
pubmed: 10197379
BMC Public Health. 2019 Nov 27;19(1):1566
pubmed: 31771552
PLoS One. 2014 Jan 22;9(1):e85478
pubmed: 24465572
Cureus. 2019 Aug 15;11(8):e5391
pubmed: 31620317
Int J Infect Dis. 2016 Aug;49:179-84
pubmed: 27401584
Int J Mycobacteriol. 2016 Jun;5(2):211-8
pubmed: 27242234
Int J Tuberc Lung Dis. 2017 May 1;21(5):493-502
pubmed: 28399963
Eur Respir J. 2016 Aug;48(2):516-25
pubmed: 27418550
PLoS One. 2013 Sep 09;8(9):e73717
pubmed: 24040038
J Clin Microbiol. 2011 Dec;49(12):4138-41
pubmed: 21956978
Front Public Health. 2019 Oct 24;7:306
pubmed: 31709218
Open Forum Infect Dis. 2019 May 17;6(6):ofz233
pubmed: 31211163
J Clin Microbiol. 2010 Jul;48(7):2495-501
pubmed: 20504986
Clin Infect Dis. 2012 Apr;54(8):1071-9
pubmed: 22318975