Adwina Nurlita Kusuma Wardhani and Retno Asih Setyoningrum*

Department of Child Health, Faculty of Medicine Airlangga University, Surabaya, Indonesia

*Corresponding Author: Retno Asih Setyoningrum, Department of Child Health, Faculty of Medicine Airlangga University, Surabaya, Indonesia.

Received: January 19, 2022; Published: January 31, 2022

Abstract

Background: The accurate diagnosis of childhood tuberculosis remains a major challenge. Molecular diagnostic tests with Xpert MTB/RIF are more rapid and cost-effective compared to the conventional culture techniques used for diagnosis and drug-resistance testing. This study aims to describe the characteristics of children with suspected tuberculosis tested with Xpert MTB/RIF in a tertiary hospital in Surabaya, Indonesia.

Methods: A descriptive study was conducted on children with suspected tuberculosis in an academic teaching hospital in Surabaya, Indonesia between January 2016 and December 2020. Clinical materials were submitted to the laboratory for examination-including sputum, pleural fluid, and gastric aspirate-and the Xpert MTB/RIF test was performed. Outcomes described as Mycobacterium Tuberculosis (MTB) detected, MTB not detected, rifampicin-sensitive, and rifampicin-resistant.

Results: Among 887 subjects during five years study period, 253 (28,5%) were sputum samples, with others from gastric aspirate, cerebrospinal fluids, feces, material from abscesses, and other biopsy specimens or resected tissue. The total number of MTB detected was 155 (17,5%) with the majority collected from 109 (70,3%) sputum samples, and the highest number of MTB Detected was found in age 10-18 years old 105/155 (67,7%). Drug sensitivity test showed 13 (8,3%) rifampicin resistance with all samples were sputum, while 142 (91,6%) subjects showed no rifampicin resistance.

Conclusions: Sputum was the largest sample collection of children tested with Xpert MTB/RIF, it showed a considerable amount of MTB positivity, with the majority aged 10-18 years old. Drug sensitivity test showed rifampicin-resistant results came from sputum samples.

Keywords: Tuberculosis; Children; Xpert MTB/RIF; Profile

References

1. Sharma SK., et al. “Evaluating the diagnostic accuracy of Xpert MTB/RIF assay in pulmonary tuberculosis”. PLoS ONE10 (2015): e0141011.
2. World Health Organization. World health statistics 2016: “Monitoring health for the SDGs, sustainable development goals”. Geneva: World Health Organization (2016).
3. Asik Hastuti E., et al. “Petunjuk Teknis Manajemen dan Tatalaksana TB Anak”. Jakarta: Kementerian Kesehatan Republik Indonesia (2016).
4. Nicol MP., et al. “Accuracy of the Xpert MTB/RIF test for the diagnosis of pulmonary tuberculosis in children admitted to hospital in Cape Town, South Africa: a descriptive study”. Lancet Infectious Disease11 (2011): 819-824.
5. Boehme CC., et al. “Feasibility, diagnostic accuracy, and effectiveness of decentralised use of the Xpert MTB/RIF test for diagnosis of tuberculosis and multidrug resistance: a multicentre implementation study”. The Lancet9776 (2011): 1495-1505.
6. Agustina B., et al. “Comparison of GeneXpert MTB to Mycobacterium tuberculosis culture in children with tuberculosis”. Paediatrica Indonesiana 59 (2019): 113-118.
7. Zeka AN., et al. “Evaluation of the GeneXpert MTB/RIF assay for rapid diagnosis of tuberculosis and detection of rifampin resistance in pulmonary and extrapulmonary specimens”. Journal of Clinical Microbiology 49 (2011): 4138-4141.
8. Walusimbi S., et al. “Meta-analysis to compare the accuracy of GeneXpert, MODS and the WHO 2007 algorithm for diagnosis of smear-negative pulmonary tuberculosis”. BMC Infectious Diseases 13 (2013): 507.
9. Bunyasi EW., et al. “Evaluation of Xpert MTB/RIF assay in induced sputum and gastric lavage samples from young children with suspected tuberculosis from the MVA85A TB Vaccine trial”. PLoS ONE11 (2015): e0141623.
10. Padmapriyadarsini C., et al. “Diagnosis and treatment of tuberculosis in HIV co-infected patients”. Indian Journal of Medical Research 6 (2011): 850-865.
11. Hillemann D., et al. “Rapid molecular detection of extrapulmonary tuberculosis by the automated GeneXpert MTB/RIF system”. Journal of Clinical Microbiology 49 (2011): 1202-1205.
12. Walters E., et al. “Xpert MTB/RIF on stool is useful for the rapid diagnosis of tuberculosis in young children with severe pulmonary disease”. Pediatric Infectious Disease Journal9 (2017): 837-843.
13. Lu Y., et al. “Evaluating the diagnostic accuracy of the Xpert MTB/RIF assay on bronchoalveolar lavage fluid: A retrospective study”. The International Journal of Infectious Diseases 71 (2018): 14-19.
14. Marais BJ., et al. “The natural history of childhood intra-thoracic tuberculosis: a critical review of literature from the pre-chemotherapy era”. The International Journal of Tuberculosis and Lung Disease 4 (2014): 392-402.
15. Sekadde MP., et al. “Evaluation of the Xpert MTB/RIF test for the diagnosis of childhood pulmonary tuberculosis in Uganda: a cross-sectional diagnostic study”. BMC Infectious Diseases1 (2013): 133.
16. Arega B., et al. “Prevalence of rifampicin resistant mycobacterium tuberculosis among presumptive tuberculosis patients in selected governmental hospitals in Addis Ababa, Ethiopia”. BMC Infectious Diseases1 (2019): 307.
17. Rarome BB., et al. “GeneXpert MTB/RIF and Mycobacterium tuberculosis sputum culture in establishing the diagnosis of pulmonary tuberculosis and rifampicin resistance in suspected childhood pulmonary tuberculosis in Soetomo Hospital”. Indonesian Journal of Tropical and Infectious Disease3 (2020): 152-162.
18. World Health Organization. COVID-19: “Operational guidance for maintaining essential health services during an outbreak: interim guidance”. World Health Organization (2020).

Citation

Citation: Adwina Nurlita Kusuma Wardhani and Retno Asih Setyoningrum. “Profile of Xpert MTB/RIF in Children with Suspected Tuberculosis in Tertiary Hospital in Surabaya, Indonesia”. Acta Scientific Paediatrics 5.2 (2022): 21-26.

Copyright

Copyright: © 2022 Adwina Nurlita Kusuma Wardhani and Retno Asih Setyoningrum. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.