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

Sorsa, Abebe; Kaso, Muhammedawel

doi:10.1371/journal.pone.0242205

Cited by 10 publications

(8 citation statements)

References 29 publications

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“…And this is typical to the finding of the study from north-western part of Ethiopia and other multicenter studies [17,18,22,21]. Also congruent with study by Abebe et al [23]. However, the study finding reported by Habte et al indicated "additional TB case detection of GeneXpert among smear AFB negative cases was 64.3%" [13], which was higher than our finding while the report from Cochrane review and meta-analysis by Steingart and his collogues, and studies from other areas were in the range of quarter which were lower than our results [19,14,[24][25][26][27][28].…”

Section: Discussionsupporting

confidence: 92%

Detection of Pulmonary Tuberculosis by Gene Xpert Method among HIV Patient in ART Center, Gadarif State, Sudan

Elbashir

Abakar²,

Nour³

2023

IJTDH

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Background: Tuberculosis (TB) is one of the most common and deadly infectious diseases in humans. Due to widespread poverty, inequity, and conflict, suboptimal health services in many countries, and the impact of the HIV/AIDS pandemic, TB/HIV co-infected patients frequently test negative for TB with direct microscopy, posing diagnostic challenges. Traditional HIV-associated TB diagnosis is complex, expensive, time-consuming, and technically demanding because it relies on conventional culture and drug susceptibility testing. The lengthy wait for results has disastrous consequences for patients who go undiagnosed or are diagnosed too late. Objective: To detect the accuracy of gene X pert® MTB/RIF as a novel automated molecular tool to diagnose Mycobacterium tuberculosis in HIV patients. Methods: A cross sectional study was conducted on 70 HIV patients suspected to have Mycobacterium tuberculosis and who were referred to the ART and Tuberculosis Centers at Gadarif state, from June 2022 to December 2022. Sputum samples were tested by two methods involved the Gene X pert (Cepheid, California, United States of America) and direct smear microscopy (SM) stained with ZN stain for detection of acid fast bacilli. Out of 70 sputum samples analyzed for acid fast bacilli, 50(71%) cases were positive using GeneXpert whereas the DM was positive only for 28 (4o %) of the cases. GeneXpert detected another 22 AFB positive cases. Therefore GeneXpert is more accurate. Sensitivity of the GeneXpert was calculated as 93% and the specificity was 43%. The majority of the patients who contributed to (SM) were found to be co-infected with HIV. Conclusion: GeneXpert demonstrated two-time case detection rate compared to the sputum smear microscopy so the direct smear showed poor performance tool for evaluation of TB-HIV co-infection. Also The Gene X pert’s sensitivity was found to be high while the specificity was low. Although this was the case, the GeneXpert as compared to DM could greatly reduce false negatives and the wait on treatment initiation can be significantly shortened, minimising premature death and continued transmission.

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Section: Discussionsupporting

confidence: 92%

Detection of Pulmonary Tuberculosis by Gene Xpert Method among HIV Patient in ART Center, Gadarif State, Sudan

Elbashir

Abakar²,

Nour³

2023

IJTDH

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“…18 The GenExpert TB diagnosis technology has increased early diagnosis of TB in HIV positives and increased survival in HIV+TB coinfection. 30 Ethiopia adopted and scaled up GenExpert diagnosis technology since 2014. 31…”

Section: Discussionmentioning

confidence: 99%

Increased Mortality in HIV Infected Individuals with Tuberculosis: A Retrospective Cohort Study, Addis Ababa, Ethiopia

Seyoum¹,

Demissie²,

Yalew³

et al. 2022

HIV

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Background Tuberculosis is one of the commonest coinfections and leading causes of death among people living with HIV in resource-limited countries. There is limited evidence on the short- and long-term mortality rate in people receiving antiretroviral therapy and coinfected by tuberculosis in sub-Saharan Africa, where the burden of coinfection is highest. Purpose This study aimed to compare mortality among HIV positives with and without tuberculosis coinfection receiving antiretroviral therapy in Addis Ababa, Ethiopia. Methods HIV positives’ medical records were reviewed between 2011 to 2018 and identified 7038 HIV-positive adults enrolled for antiretroviral therapy in Addis Ababa. The outcome of interest for this study was death. A parametric Gompertz regression model was applied to compare mortality between HIV with tuberculosis coinfection versus HIV without tuberculosis. Results Overall, 1123 (15.96%, 95% CI: 15.11–16.83%) individuals with HIV had tuberculosis coinfection at antiretroviral therapy enrollment. After adjusting for age, sex, education, marital status, cotrimoxazole therapy, body mass index, baseline CD4 cell count, and year in ART enrollment, HIV positives with tuberculosis coinfection had more than twice a higher overall mortality risk than HIV positives without tuberculosis coinfection (AHR: 2.53; 95% CI 1.63–3.91, p < 0.001). Conclusion This large retrospective cohort study reveals significantly higher mortality in HIV and tuberculosis coinfected group. This suggests the need for enhanced utility of integrated HIV and tuberculosis health services in sub-Saharan Africa where tuberculosis prevalence is highest.

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“…The limitations of the present study are that, although this comparison models a common and emblematic differential diagnosis, the back-to-back comparison of disseminated histoplasmosis and tuberculosis is reductive and falsely dichotomizes real clinical situations with advanced HIV, where other differential diagnoses may be evoked. The diagnosis of disseminated histoplasmosis and tuberculosis relied on microbiology, the gold standard, but we now know that the sensitivity of these methods is lower than other methods of antigen testing for disseminated histoplasmosis or Gene Xpert for tuberculosis [22]. Therefore, perhaps there are a number of more difficult diagnoses that are not captured by this model.…”

Section: Discussionmentioning

confidence: 99%

A Simple Predictive Score to Distinguish between Disseminated Histoplasmosis and Tuberculosis in Patients with HIV

Alsibai

Epelboin

Abboud

et al. 2021

JoF

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Disseminated histoplasmosis is a common differential diagnosis of tuberculosis in disease-endemic areas. We aimed to find a predictive score to orient clinicians towards disseminated histoplasmosis or tuberculosis when facing a non-specific infectious syndrome in patients with advanced HIV disease. We reanalyzed data from a retrospective study in Cayenne Hospital between January 1997–December 2008 comparing disseminated histoplasmosis and tuberculosis: 100 confirmed disseminated histoplasmosis cases and 88 confirmed tuberculosis cases were included. A simple logit regression model was constructed to predict whether a case was tuberculosis or disseminated histoplasmosis. From this model, a score may be obtained, where the natural logarithm of the probability of disseminated histoplasmosis/tuberculosis = +3.917962 × WHO performance score (1 if >2, 0 if ≤2) −1.624642 × Pulmonary presentation (1 yes, 0 no) +2.245819 × Adenopathies > 2 cm (1 yes, 0 no) −0.015898 × CD4 count − 0.001851 × ASAT − 0.000871 × Neutrophil count − 0.000018 × Platelet count + 6.053793. The area under the curve was 98.55%. The sensitivity of the model to distinguish between disseminated histoplasmosis and tuberculosis was 95% (95% CI = 88.7–98.3%), and the specificity was 93% (95% CI = 85.7.3–97.4%). In conclusion, we here present a clinical-biological predictive score, using simple variables available on admission, that seemed to perform very well to discriminate disseminated histoplasmosis from tuberculosis in French Guiana in well characterized patients.

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

Cited by 10 publications

References 29 publications

Detection of Pulmonary Tuberculosis by Gene Xpert Method among HIV Patient in ART Center, Gadarif State, Sudan

Detection of Pulmonary Tuberculosis by Gene Xpert Method among HIV Patient in ART Center, Gadarif State, Sudan

Increased Mortality in HIV Infected Individuals with Tuberculosis: A Retrospective Cohort Study, Addis Ababa, Ethiopia

A Simple Predictive Score to Distinguish between Disseminated Histoplasmosis and Tuberculosis in Patients with HIV

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