الفهرس 
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Abstract
The rapid diagnosis of tuberculosis (TB) is essential for early disease management. GeneXpert test is a novel rapid diagnostic modality. In this study, we aimed to evaluate the diagnostic role of GeneXpert test in diagnosing PTB in children as well as detection of rifampicin resistance.PTB was significantly higher in females in older age group.EPM were significantly more frequent in young age. Hilar lymphadenopathy (on CXR) was significantly more frequent in young age. Positive TST reactions were significantly more frequent in older age.
Positive geneXpert results were significantly more frequent in older age and adolescents. Positive geneXpert was found in 30(37.5%) out of 80 cases. In positive cases, rifampicin resistance was detected in two patients (6.6%).
Positive geneXpert results were significantly more frequent in expectorated sputum samples than gastric aspirate samples. Positive geneXpert results were significantly more frequent in cases with absent BCG scar. Positive geneXpert results were significantly more frequent in cases with hemoptysis and cases with failure to thrive. Positive geneXpert results were significantly more frequent in cases with cavitary lung lesions. Cases with positive Xpert had significantly lower mean hemoglobin than negative cases. Positive geneXpert results were significantly more frequent in cases with positive blood PCR and cases with positive ZN stain.
Conclusions:
1- GeneXpert assay was positive in 37.5% of cases, which is a satisfactory result. Therefore, geneXpert can be a useful tool for diagnosis of patients with high clinical suspicion of PTB, as it is a simple, rapid, and accurate method for detecting mycobacterial tuberculosis.
2- GeneXpert is better than blood PCR and ZN stain in diagnosing PTB in children.
3- GeneXpert is a simple, rapid, and accurate method for diagnosing PTB in children.
4- There were 6.7% of our patients who were rifampicin resistant by geneXpert.
Recommendation:
1-We recommend using GeneXpert as an initial diagnostic test for PTB in children.
2- Children suspected of having PTB but who have had a single negative result by Xpert MTB/RIF should repeat the assay or undergo further diagnostic testing.
3-Further studies are needed to evaluate the use of GA, IS and stool samples for geneXpert assay in pediatric PTB.
4-Detailed protocols for procedures for obtaining respiratory samples(as expectorated sputum, IS or GA) should be included in the resident program for training them how to deal with diagnosis of pediatric PTB.
5- Although rifampicin resistance in uncommon, yet it should be considered.