Optimizing Tuberculosis Diagnosis: The Role of GeneXpert in Smear-Negative Cases

Authors

Abstract

Objective: To observe the efficiency of GeneXpert in confirmation of smear negative pulmonary TB cases.

Methods

This descriptive study was conducted at HRI-NIH TB Research Centre King Edward Medical University/ rd th Mayo Hospital Lahore during 23 December 2020 to 26 May 2021. Those smear negative patients who already started their anti-tubercular treatment and coming for follow-up were not included in this study. After taking informed consent patients suspected of having pulmonary tuberculosis on clinical and radiological grounds but negative sputum smear microscopy were asked to provide a spot sputum specimen in a sterile container and GeneXpert MTB/RIF assay was performed.

Results

  A total of 116 smear negative patients consisted of 64 (55.2%) females and 52 (44.8%) males with male to female ratio of 1:1.23. Mean age of patients was 39.7±15.46 with minimum age of patients as 18 years and maximum of 72 years. Presenting complaints were also recorded; low grade fever and weight loss were present in 100% patients while fatigue was also present in 90.5% patients and anorexia in 83.6% cases. A total of 21 (18.0%) smear negative patients came back as positive for MTB on GeneXpert; of these 13/21 (61.9%) were reported as showing very low quantity and remaining 8/21 (38.1%) showed low quantity while none of the patients showed Rifampicin resistance on GeneXpert.

Conclusion

 Diagnostic delay of smear negative pulmonary TB could be improved by using GeneXpert as 18% smear negative TB cases were confirmed by using this technique in this study which ultimately can prevent considerable morbidity and mortality.

Keywords:

Tuberculosis, GeneXpert, Early diagnosis, AFB smear.

Published

2025/06/05