The Concordance Between Xpert Mtb/rif, Microscopy and Culture for Presumed Tuberculosis Patients at the Cape Coast Teaching Hospital

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.