Assessment of Extrapulmonary Tuberculosis Using Gene Xpert MTBRIF Assay and Fluorescent Microscopy and Its Risk Factors at Dessie Referral Hospital, Northeast Ethiopia

Abstract EN

Background.

Tuberculosis is a major public health problem and extrapulmonary tuberculosis (EPTB) accounts for a significant proportion of tuberculosis cases worldwide.

Objective.

To determine the magnitude of EPTB, associated risk factors, and agreement of diagnostic techniques at Dessie Referral Hospital.

Methods.

A cross-sectional study was conducted on consecutive presumptive EPTB cases from March 1 to June 30, 2017.

Sociodemographic characteristics and other variables were collected using a structured questionnaire.

Clinical specimens were collected and processed using fluorescent microscopy and Gene Xpert assay.

Data was analyzed using SPSS version 20.

Chi-square test and logistic regression were done and a P value of ≤0.05 was taken as statistically significant.

Results.

From a total of 353 presumptive EPTB cases the overall prevalence of Gene Xpert assay and smear confirmed patients was 8.8% and 2.5%, respectively.

Tuberculosis lymphadenitis was the predominant (33.3%) type followed by pleural (11.9%) and peritoneal (6.7%) tuberculosis.

Previous history of pulmonary tuberculosis was significantly associated with extrapulmonary infection (AOR:2.8; 95%CI: 1.05-7.54; p=0.04); however, other variables such as age, residence, sex, marital status, occupation, level of education, and monthly income did not show any association.

Conclusion.

High proportions (71%) of Gene Xpert assay confirmed EPTB patients were smear-negative.

Sensitivity of microscopy should be enhanced in resource limited countries like Ethiopia where Gene Xpert machine is not easily accessible.