Dataset Information

Diagnostic performance of GeneXpert in tuberculosis-HIV co-infected patients at Asella Teaching and Referral Hospital, Southeastern Ethiopia: A cross sectional study.

ABSTRACT:

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.

SUBMITTER: Sorsa A

PROVIDER: S-EPMC7840185 | biostudies-literature | 2021

REPOSITORIES: biostudies-literature

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Publications

Diagnostic performance of GeneXpert in tuberculosis-HIV co-infected patients at Asella Teaching and Referral Hospital, Southeastern Ethiopia: A cross sectional study.

Sorsa Abebe A Kaso Muhammedawel M

PloS one 20210127 1

<h4>Background</h4>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.<h4>Methods</h4>Cross-sectional study was conducted by recruiting individuals attending an HIV clinic from February 2018 to January 2019. Data on clinical parameters were collec ...[more]

PMID: 33503051

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Project description:BackgroundDiagnosis of tuberculosis (TB) in children is challenging mainly due to the difficulty of obtaining respiratory specimen and lack of sensitive diagnostic tests. The objective of this study was to evaluate the diagnostic performance of Xpert MTB/RIF (Xpert here after) for the diagnosis of pulmonary TB (PTB) from stool specimen in children.MethodsA cross-sectional study was conducted among consecutively recruited children (less than 15 years old) with presumptive PTB at Jimma Medical Center, Ethiopia. One pulmonary specimen (expectorated sputum or gastric aspirate) was collected from each participant and tested for TB by Xpert and Lowenstein-Jensen (LJ) culture. In addition, one stool specimen per child was collected and tested by Xpert after a single step, centrifuge-free stool processing method adapted from KNCV TB Foundation. Diagnostic performance of Xpert was calculated with reference to LJ culture and to a composite reference standards (CRS) comprising of confirmed TB (positive by Xpert and/or culture) and unconfirmed TB (clinical diagnosis with improvement after anti-TB treatment).ResultsA total of 178 children were enrolled; 152 of whom had complete microbiological results. Overall, TB was diagnosed in 13.2% (20/152) of the children with presumptive TB. Of these, only ten had microbiologically confirmed TB (positive Xpert and/or culture) and the remaining ten were clinically diagnosed with positive response to anti-TB treatment and were classified as unconfirmed TB. Stool Xpert had sensitivity of 100% (95%CI: 66.4-100) and specificity of 99.3% (95%CI: 96.2-100) compared to culture; however, the sensitivity was decreased to 50% (95%CI: 27.2-72.8) when compared to CRS. The Xpert on gastric aspirate had sensitivity of 77.8% (95%CI: 40-97.2) compared to culture and 40% (95%CI: 19.1-64) compared to CRS.ConclusionsThe sensitivity of Xpert for stool sample is comparable to that for gastric aspirate. Stool sample is a potential alternative to pulmonary specimen in the diagnosis of pulmonary TB in children using Xpert.

Project description:Background:The primary goal of asthma management is to achieve good asthma control. However, poor patient-physician communication, unavailability of appropriate medications, and lack of long-term goals have made asthma control difficult in developing countries. Poor assessment of asthma control and quality of life is a major cause of suboptimal asthma treatment worldwide, and information regarding this issue is scanty in developing countries like Ethiopia. This study thus attempted to assess the level of asthma control and quality of life in asthmatic patients attending Armed Forces Referral and Teaching Hospital. Methods:A cross-sectional study comprising 184 physician-diagnosed asthmatic patients was conducted using interview, chart review, and prescription assessment. Asthma control was assessed using Asthma Control Test, while asthma quality of life was assessed using Mini-Asthma Quality of Life Questionnaire (mini-AQLQ). Spearman's rank correlation analysis was performed to understand the relationship between mean mini-AQLQ score and asthma control. Receiver operating characteristic curve analysis was performed to establish cut-off values for mini-AQLQ. Results:Asthma was uncontrolled in 67.9% subjects. There was a strong correlation between asthma control and quality of life (rs = 0.772; P < 0.01). A cut-off value for the quality of life was established at 4.97. Majority of the patients were taking two or three antiasthmatic drugs. Oral tablet and inhaler short-acting beta agonists (SABA) were the frequently combined drugs. Uncontrolled asthma was associated with middle-aged adults (adjusted odds ratio (AOR) = 6.31; 95% CI: 2.06, 19.3; P = 0.001), male gender (AOR = 0.38; 95% CI: 0.15, 0.98; P = 0.044), married (AOR = 0.24; 95% CI: 0.08, 0.78; P = 0.017), comorbidities (AOR = 0.23; 95% CI: 0.09, 0.61; P = 0.003), and oral SABA use (AOR = 0.22; 95% CI: 0.09, 0.59; P = 0.003). Male gender (AOR = 0.36; 95% CI: 0.16, 0.84; P = 0.018), intermittent asthma (AOR = 0.18; 95% CI: 0.04, 0.86; P = 0.032), use of oral corticosteroids (AOR = 0.22; 95% CI: 0.06, 0.73; P = 0.013), and SABA (AOR = 0.39; 95% CI: 0.17, 0.89; P = 0.026) were found to have a significant association with poor asthma-related quality of life. Conclusion:The findings collectively indicate asthma remains poorly controlled in a large proportion of asthma patients in the study setting. Moreover, quality of life appears to be directly related to asthma control. Healthcare providers should therefore focus on asthma education with an integrated treatment plan to improve asthma control and quality of life.

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Dataset Information

Diagnostic performance of GeneXpert in tuberculosis-HIV co-infected patients at Asella Teaching and Referral Hospital, Southeastern Ethiopia: A cross sectional study.

Background

Methods

Result

Conclusion

Publications

Diagnostic performance of GeneXpert in tuberculosis-HIV co-infected patients at Asella Teaching and Referral Hospital, Southeastern Ethiopia: A cross sectional study.

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