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Abstract

Comparative Analysis of Ziehl-Neelsen and Genexpert Techniques for the Diagnosis of Tuberculosis in Human Immuno-Deficiency Virus Positive Patients in Benin City

Mycobacterium tuberculosis is the second most common infectious cause of death in adults worldwide (HIV is the most common). The human host serves as the natural reservoir for M. tuberculosis. The ability of the organism to efficiently establish latent infection has enabled it to spread to nearly one-third of individuals worldwide. Approximately eight million new cases of active TB disease occur each year, leading to about 1.7 million deaths. The disease incidence is magnified by the concurrent epidemic of human immunodeficiency virus (HIV) infection. A total of 362 sputum specimens from 181 presumptive tuberculosis suspects of patients living with Human Immuno-Deficiency virus were tested using direct smear staining technique of ZiehlNeelsen and GeneXpert for the detection of MTB/RIF. The performance of Xpert MTB/RIF technique was compared withZiehl- Neelsentechnique, out of the 181 persons, 148 were smear negative (81.8%) and 33 were smear positive (18.2%), while for the Genexpert MTB/RIF technique, 115 (63.5%) were MTB not detected (negative), 59 (32.6%) MTB detected, RIF resistance not detected and RIF resistance detected, 4 (2.2%) error and 3 (1.7%) incomplete. Thirty-three (33) patients (18.2%) were TB positive with both techniques, Twenty-six patients (14.4%) were GeneXpert/RIF positive but ZN staining technique negative and 110 patients (60.7%) were negative with both methods. The positivity rate for MTB detected for Genexpert technique in female was 32 (58.2%) and male 23 (39.0%), while ZN staining technique in female was 15 (45.5%), and male 18 (54.5%). From this study, it was observed that Genexpert technique detected more tuberculosis cases than Ziehl-Neelsen technique. Amongst people living with Human Immuno-Deficiency virus, female are more diagnosed of tuberculosis than male with age range of 25-49 years having the highest positive result and the least positive result in age range 15-19 years 4 (2.2%), male 3 (1.7%) and female 1 (0.5%). Age distribution shows age group 25-49 years old with the highest number 120 (66.7%), with male 45 (25.0%)and female 75 (41.7%), followed by age group 50 years old and above 36 (20.0%), male 11 (6.1%) and female 25 (13.9%), then followed by age group 7-14 years old 13 (7.2%), male 8 (4.4%) and female 5 (2.8%). Age group 20-24 years old had 7 (3.9%), male 5 (2.8%)and female 2 (1.1%) and the least, age group 15-19 years old 4 (2.2%), male 3 (1.7%) and female 1 (0.5%). The sensitivity and specificity ratio were 85% and 97%. The integration of molecular techniques such as Genexpert in the identification of M. tuberculosis complex is recommended as this can provide timely intervention in the diagnosis and treatment of tuberculosis.


Author(s):

Ochei Kingsley Chinedum, Adagbonyin Emwiomwan, Obeagu Emmanuel Ifeanyi and Aminu Babayi



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