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Missed Opportunities for Diagnosing bacilliferous pulmonary tuberculosis by Optical Microscopy versus GeneXpert MTB/RIF in Endemic Areas

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Advances in Infectious Diseases 2023年第4期13卷 652-659页

作者： Aba Yapo Thomas Nassoué Dobré Olivia Yéo Liomehin Monemo Pacome Yapo Matine Tatiana Achi Hoboueu Vincent Department of Infectious and Tropical Diseases University Hospital of Bouake Bouake Ivory Coast University Alassane Ouattara of Bouake Bouake Ivory Coast Department of Pneumology University Hospital of Bouake Bouake Ivory Coast Department of Bacteriology & Virology University Hospital of Bouake Bouake Ivory Coast

Objective: To assess the missed opportunities from the diagnosis of bacilliferous pulmonary tuberculosis by optical microscopy compared to GeneXpert MTB/RIF between 2015 and 2019. Methods: This is a retrospective analysis of the diagnostic results of bacilliferous pulmonary tuberculosis in patients suspected of pulmonary tuberculosis at their first episode during the period. GeneXpert MTB/RIF (GeneXpert) and optical microscopy (OM) after Ziehl-Neelsen stained smear were performed on each patient’s sputum or gastric tubing fluid sample. Results: Among 341 patients suspected of pulmonary tuberculosis, 229 patients were declared bacilliferous tuberculosis by the two tests (67%), 220 patients by GeneXpert and 95 patients by OM, i.e. 64.5% versus 28% (p i.e. 58.5% of the positive cases detected by the two tests (134/229 patients) and 39.3% of the patients suspected of tuberculosis (134/341 patients). On the other hand, among 95 patients declared positive by OM, the GeneXpert ignored 9 (9.5%), i.e. 4% of all the positive cases detected by the two diagnostic tests (9/229 patients) and 3% of the patients suspected of tuberculosis (9/341 patients). The differences observed between the results of the two tests were statistically significant at the 5% threshold (p Conclusion: This study reveals missed diagnostic opportunities for bacilliferous pulmonary mycobacteriosis, statistically significant with optical microscopy than GeneXpert. The GeneXpert/optical microscopy couple could be a good contribution to the strategies for the elimination of pulmonary tuberculosis in sub-Saharan Africa.

关键词： bacilliferous pulmonary tuberculosis Missed Opportunity GeneXpert MTB/RIF Optical Microscopy

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