Prevalence of GeneXpert Positive in Sputum Negative with Clinico-radiologically Case Suggestive of Pulmonary Tuberculosis.

Abstract

Introduction: Tuberculosis remains of public health concern, particularly in highly endemic regions.1 It accounts globally for 3 million deaths annually. Pulmonary tuberculosis is primarily diagnosed by identification of Mycobacterium tuberculosis using sputum smear microscopy.2 Clinicians often depend on alternative diagnostic algorithms based on patient symptoms and chest X-ray findings, which have low sensitivity which may lead to either over or under diagnosis of pulmonary tuberculosis. The GeneXpert assay has been shown to have an accuracy comparable to that of culture.3 The sensitivity of a single GeneXpert result in smear-negative, culture-positive cases is 72.5%; the sensitivity increases with repeated testing.4 Xpert has been found to be a cost-effective method for smear-negative TB diagnosis in comparison to traditional methods in resource-limited settings. The aim of the study was to find the prevalence of Genexpert Positive in Sputum negative cases.

Methods: This descriptive cross sectional study was done in Bir Hospital, Mahabouddha, Kathmandu for 1 year after taking ethical clearance. Data was collected and entry was done with point estimate at 95%. Sample size was calculated using the standard formula. Convenience Sampling technique was used, data analysis was done with SPSS Microsoft Excel Sheet.

Results: Prevalence of Genexpert Positive in Sputum negative cases was part to be 27.27%.

Conclusions: Present study showed GeneXpert could be used as a diagnostic tool for the diagnosis of tuberculosis by correlating the clinicoradiological features to this infectious disease. With judicious case detection and implementing appropriate measures, TB incidence, prevalence and morbidity can be minimized to a greater extent.

Keywords: acid fast bacilli; tuberculosis; X-ray.