Performance of Genexpert in the diagnosis of tuberculosis in children in comparison with smear microscopy and MGIT culture and detection of drug resistant cases at HMC, Peshawar

Abstract

Objectives: To determine the performance of Genexpert in detecting Mycobacterium Tuberculosis in children compared
with microscopy and MGIT culture and determining the sensitivity pattern of Mycobacterium Tuberculosis in children
at Hayatabad Medical Complex, Peshawar.
Study Design: This is cross-sectional observational study.
Duration and Place: This study was carried out from 1st January, 2019 to 31st December, 2019 at Pediatric B Unit,
Hayatabad Medical Complex, Peshawar.
Materials and Methods: Data was extracted from the database of TBC Center, Hayatabad Medical Complex, Peshawar.
It was analyzed with descriptive statistics using SPSS Version 26 and the results were presented in figures.
Results: 274 patients were included in the study. 121 (44.16%) were females and 153 (55.84%) were males. The mean
age was 9.77±3.92 years having a range of 1-15 years. 205 had pulmonary disease while 69 patients had extra pulmonary
disease. Among those with pulmonary disease 97 were females and 105 were males. Among extra pulmonary cases
24 were females and 45 were males. Smear microscopy was positive in 14 cases, culture was positive in 16 cases and
Genexpert was positive in 37 cases. In the cases in whom tuberculosis was detected by Genexpert, 30 (24 females 6
males ) had pulmonary disease while 7 patients (6 females 1 male) had extra pulmonary disease. Drug resistance was
detected in one patient showing resistantance to Rifampicin, Isoniazid, Pyrazinamide and Ofloxacin and sensitivity to
Ethambutol, Amikacin, Kanamycin, Moxifloxacin and Capreomycin.
Conclusions: The performance of genexpert is far better than microscopy and culture for the diagnosis of tuberculosis
in children and in detecting multidrug resistant disease.