Abstract:
Sputum Smear Microscopy (SSM) is time-honoured tuberculosis (TB) detection
tool in resource-constrained settings such as Ghana. However, sensitivity and
specificity are low. The purpose of this retrospective study, which included 494
archived samples, was to assess the degree of agreement between TB detection by
Xpert MTB/RIF, SSM, and Culture (LJ media) diagnostic tests in presumed TB
patients at Cape Coast Teaching Hospital (CCTH). At the CCTH, all archived
samples have already undergone Xpert MTB/RIF tests. In this study, all of the
archived samples were cultured and microscopically examined. Age, gender,
HIV status, and diagnostic test type were among the variables of interest. Using
STATA version 16, SSM and microscopy data from positive TB cases diagnosed
were compared to Xpert MTB/RIF diagnoses using a two-sample proportional
test. Logistic regression was used to determine the strength of the association and
the factors associated with positive TB cases. Overall, the proportion of TB cases
detected by SSM was 19.3 (13.9 – 25.6 %) compared to 22.2 (17.3 – 27.8). The
specificity of Xpert MTB/RIF, as opposed to tradition, changed into additionally
lower: 92.5 (89.0 – 95.2%) as opposed to 99.6 (97.6 – 100.0%). (p = 0.001) The
kind of diagnostic device used changed into found to be notably associated with
the detection of nice TB cases (p = 0.01). This study emphasizes the importance
of using Xpert MTB/RIF, as molecular diagnostics are number one in diagnosing
TB despite limited resources. It also highlights the importance of using SSM with an MTB/RIF expert and the tradition of selecting different types of NTM-containing mycobacteria.
