Impact of GeneXpert MTB/RIF for Rapid Tuberculosis Diagnosis and Rifampicin Resistance Detection in South-Western Nigeria

Abstract

Mycobacterium tuberculosis (MTB) still remains a major public health issue, with the disease estimated to cause approximately 9 million cases annually and 1.5 million deaths. Xpert MTB/RIF is described as a game changer in tuberculosis control of tuberculosis. This study assessed the impact of using Xpert for tuberculosis diagnosis and the efficiency in terms of tuberculosis treatment initiation in selected tuberculosis clinics in South-Western Nigeria. A total of 300 consenting patients between 15 to 60 years of age attending tuberculosis clinic were recruited into this prospective cohort study from January 2015 to June 2017 and evaluated for pulmonary or extrapulmonary tuberculosis. Written consent was obtained from every participant and ethical clearance was obtained from the Ethical Review Committee of the Federal Teaching Hospital Ido Ekiti, Nigeria. Data was analysed using SPSS software, with significance fixed at p<0.05. The mean age ± SD is 37.11 ± 15.27 years. One hundred and thirty-five (45.0%) of them are males while one hundred and sixty-five (55.0%) are females. Two hundred and eighty-four patients (94.7%) were diagnosed of pulmonary tuberculosis (PTB), with two hundred and eighty-two (94.0%) being new tuberculosis patient. MTB detected and rifampicin (RIF) resistance not detected was detected in two hundred and seventy-six patients (92.0%) while MTB detected; RIF resistance detected was reported in two (0.7%) of the patients who tested smear microscopy positive at varying levels before treatment commencement. There was a significant association between site of infection and tuberculosis treatment outcome, as 233 (77.7%) of the patients were declared cured. The Xpert MTB/RIF technique has great performance for rapid diagnosis of Mycobacterium tuberculosis with 93% sensitivity especially as it helps fast track tuberculosis treatment initiation.