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A cross sectional study was conducted in Abbasia chest hospital to study the validity of GenXpert and to compare it with validity of direct smear microscopy in diagnosing pulmonary TB. It also aimed to describe the resistance pattern and the treatment outcome of TB cases (January 2016 to February 2018).
The study included 393 clinically suspected cases attending Abbasia chest hospital seeking medical care). All cases underwent direct smear microscopy, GX MTB/RIF and Lowenstein–Jensen Culture as Golden standard test for diagnosis of TB.
The study revealed the, prevalence of TB among examined cases by TB culture (Golden Diagnostic test), sputum Microscopy and GenXpert assay to be 49.9%, 42.2% and 52.4% respectively.
The sensitivity and specificity of the Genxpert were 91.8% and 86.8% respectively in diagnosis of TB with substantial agreement with the culture results was (78.6%). Genxpert also has a sensitivity of 100% and specificity of 98.9% in diagnosing rifampicin resistant tuberculosis with substantial agreement of 96 % with the DST culture.
The validity of the expert is much higher than that of direct smear microscopy which had 53.6% sensitivity and 69% specificity and agreement of 22.6%.
TB positive cases completed the DST to determine the anti TB drug resistance pattern. Almost 76.5 % of the cases were sensitive and 23.5 % developed secondary resistance during the follow up period. The highest resistance was for Rifampicin 16.3% followed by Streptomycin 9.7%, INH 9.2% and lastly Ethambutol 4.1%.
Follow up of the TB positive cases were done to determine the treatment outcome among the TB positive cases and the MDR. The results revealed that 85% of patients were cured and 14.7% had unsuccessful outcome (defaulter 5.3%, failure of treatment 6.2% and death rate of 3.1%).