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allied
academies
September 20-21, 2017 | Philadelphia, USA
Global summit on
TUBERCULOSIS AND LUNG DISEASE
Int J Respir Med 2017 Volume 2 Issue 2
Background:
HIV remains the strongest risk factor for Tuberculosis (TB).The World
Health Organization (WHO) recommended genexpert technology as the initial
diagnostic test for individuals suspected of having Multi Drug Resistance TB (MDR-TB)
or HIV and TB. However, access to modern diagnostic technique like Genexpert is still
poor in low and middle income countries where many laboratories are underfunded
and sputum microscopy still remains only available TB diagnostic method. Using the
hub and spoke matric model, Management Science for Health with funding from
USAID in July 2015 rolled out financial support for transportation and logging of
sputum samples for Genexpert investigation from 6 remote local governments and
hospitals to Federal Medical Center Birnin Kebbi, Northwestern Nigeria where the
Genexpert machine is domiciled.
Objective:
The objective of the study is to determine capacity of Sputum Alcohol Acid
fast bacilli (AAFB) compared with genexpert technology in the diagnosis of TB/HIV co-
infection and multidrug resistance TB with the view to argue for increased roll out of
better diagnostic approach in low resource settings.
Methodology:
By reviewing 9-month (July 2015 and March 2016) Sputum investigation
data in both Sputum AAFB as well as Genexpert registers, data were disaggregated
into no of samples collected in the review period, HIV positive and negative samples,
samples with unknown status, No of Mycobacterium TB (MTB) and MDR-TB detected
in the total samples, samples with MTB and MDR-TB among the total HIV positive
samples that were processed in both AFB and genexpert registers for the review
period. This helped to analyze MDR-TB cases and compare the MTB/HIV as well as
MDR-TB/HIV co-infected rates for both investigations.
Results:
Genexpert technology has higher MTB/HIV (8.24%) as well as higher MDR-
TB/HIV co-infection (3.12%) detection rates compared with sputum AAFB with MTB/
HIV and MDR-TB/HIV co-infection detection rates of 3.12% and 0% respectively. 15.7%
and 0% of total samples sent for AAFB were MTB and MDR-TB detected respectively
while 15.9% and 1% of total samples for genexpert were MTB and MDR-TB detected
respectively. 83% and 12%of sputum samples sent for AAFB and Genexpert respectively
have unknown HIV status.
Conclusion:
Genexpert technology has been shown to be a better diagnostic tool in
detection of TB/HIV co-infection and multidrug resistance TB but comparative capacity
to detect
MTB.TB/HIVcollaboration is important to scale up HIV testing in TB settings
which is still low. Governments and donors need to scale up genexpert technology
for improved access to TB diagnosis in low resource settings. Further studies need to
investigate access of the TB/HIV co-infected and MDR-TB cases to anti-TB drugs and
impact of early detection with genexpert technology on treatment outcomes in this
setting.
e:
schrodinga05@yahoo.comA comparative analysis of Xpert MTB/RIF Versus AAFB Smear in the diagnosis of suspects of TB/HIV
and multidrug Resistant TB: a nine-month retrospective data from Northwestern Nigeria
Victor Abiola Adepoju
Nigeria