Abstract
Introduction
Pakistan ranks 5thglobally in MDR TB. There is urgent need to scale up diagnosis and management of MDR TB. GeneXpert MTB/RIF Assay is being used to detect TB and R resistant. This study was done to evaluate GeneXpert MTB/RIF Assay for Rapid Diagnosis of Tuberculosis and Detection of R Resistance in high risk groups that is Patients requiring retreatment and drug resistant TB contact
Method
Patients requiring retreatment and contact of drug resistant TB visiting outpatient of Ojha institute of chest diseases Karachi during 2013 were screened for tuberculosis by sputum microscopy, GeneXpert MTB/RIF Assay and conventional culture.
Result
560 sputum specimens from 543 patients were tested. 120 were DR-TB contacts and rest were retreatment cases, among them 297, 106 and 01 have received category 1,2and 4 respectively. 19 were others.
Among contacts 29 (24.16) were sputum positive, and 39(32.2%) GeneXpert MTB positive. 02(1.66%) were Rifampacin(R) Resistance.
In patients requiring retreatment 355(83.9%) were sputum positive and 354(83.1%) were GeneXpert MTB positive. 99(23%) were R Resistant.
The results of R Resistance on conventional culture and sensitivity were identical.
Conclusion
GeneXpert MTB detected 8% more cases of TB in DRTB contacts, while the yield was equal in retreatment cases.
R resistance in DRTB contacts was only 1.66% which is not higher than new reported TB cases in any setting in Pakistan. GeneXpert MTB detected R resistance in 23% retreatment cases.
- © 2014 ERS