الفهرس 
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Abstract
Tuberculosis (TB) is chronic infectious, granulomatous, communicable, multisystem, but preventable and curable disease.
TB transmits by inhalation of minute droplets produced by coughing or sneezing from infected person.
Tuberculosis is one of the top 10 causes of death and the leading cause from a single infectious agent (Ranking above HIV). One fourth of the world‘s population, is infected with TB. Every year millions of people fall sick with TB. Globally in 2017 it is estimated that 10.0 million people developed TB disease, and of these 6.4 million are new cases of TB.
In 2017, there are million of deaths caused by TB among HIV-negative people and there were an additional 300 000 deaths from TB among HIV-positive people.
Drug-resistant TB remains a public health problem. In 2017 it is estimated that, thousands of people developed TB that was resistant to rifampicin (RR-TB), and many of them, had multidrug-resistant TB (MDR-TB). MDR/RR-TB include new TB cases and previously treated cases.
The Xpert MTB/RIF assay is a new test that changes tuberculosis (TB) control radically by providing rapid diagnosis of TB disease and drug resistance.
The aim of this study to assess the usefulness of Gene Xpert MTB/RIF technique in diagnosing patient with pulmonary TB (PTB) from patients with suspected PTB. It included 150 patients divided into 2 groups.
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group I: patients in whom MTB were detected and include a bacteriologically confirmed TB case.
group II: patients in whom MTB not detected and include: (a) unconfirmed tuberculosis and (b) unlikely tuberculosis.
Inclusion criteria:
Patient with clinical symptoms suggestive or confirmed diagnosis of pulmonary TB (PTB) e.g:
1. Cough for more than 2 weeks.
2. Persistent low grade fever.
3. Loss of weight.
4. Hemoptysis.
o Radiological finding consistent with TB.
o Availability of sputum Gene Xpert result.
Exclusion criteria:
Patients with symptoms of extra-pulmonary TB or any disease other than PTB.
Patients with incomplete data.
As regarding the retrospective part data were recruited from the files of patient and were included:
1. Patient history.
2. Clinical general and local chest examination.
3. Laboratory investigations:
a) Sputum samples: for ZN stain smear microscopy, Gene Xpert MTB/RIF, Culture for AFB.
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b) Blood samples: ESR, CBC, Fasting blood glucose (FBG), HIV-1/2
4. Radiology as Chest X-ray.
As regarding the prospective part, each patient underwent:
Detailed history taking including: age, sex, residence (rural and urban), weight, special habits, respiratory symptoms, history of previous TB, and history of comorbid diabetes Mellitus DM.
Clinical examination: a detailed general and local chest examination.
Laboratory investigations:
a) Sputum samples for ZN stain smear microscopy, Gene Xpert MTB/RIF, Culture for AFB.
b) Blood samples: HIV-1/2, CBC, ESR, Fasting Blood glucose FBG.
Radiology include: Chest X-ray, CT of chest if indicated.
It was found that:
Age was significantly lower in group I compared to group II.
Female gender was significantly lower than male gender between two groups.
There was no statistically significant difference between two group regarding residence.
There was statistically significant difference between two groups regarding smoking status except Goza smoker showed non significance.
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History of previous TB was highly significantly lower in group I compared to group II.
There was no statistically significant difference regarding history of comorbid DM between two groups.
Symptom of TB was significantly lower in group II compared to group I except for hemoptysis showed non significance.
There was statistically significant difference regarding radiological findings (patch,nodule, other) between two groups while other findings showed non significance (normal finding, cavity, micronodule).
Anemia was significantly lower in group II compared to group I.
Leukocytosis was significantly lower in group I compared to group II.
There was no statistically significant difference between two groups regarding FBG, HIV1/2
RIF resistance was significantly lower in group II compared to group I.
ESR first hour was significantly lower in group II compared to group I.
GeneXpert positivity was 65.9% while smear positivity was 61.1%.
Previous history of TB was a significant predictor of GeneXpert positivity, previous history of TB and sputum smear positivity were significant predictors of rifampicin resistance.