Xpert MTB/RIF assay did not improve diagnosis of pulmonary tuberculosis among child contacts in Rwanda
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Date
2018
Journal Title
Journal ISSN
Volume Title
Publisher
African Field Epidemiology Network
Abstract
INTRODUCTION: To report on the diagnostic yield using the Xpert MTB/RIF assay on gastric lavage samples from children (<15 years) who were
household contacts of tuberculosis (TB) cases in Kigali, Rwanda. METHODS: A cross-sectional study was conducted among 216 child contacts of
index cases with sputum smear-positive TB over a 7 month period, from 1st August 2015 to 29th February 2016. Child contacts with tuberculosisrelated
symptoms or abnormal chest X-ray had sputum collected by gastric lavage on two consecutive days and samples were examined by smear
microscopy, Xpert MTB/RIF assay and solid culture. RESULTS: Of the 216 child contacts, 94 (44%) were less than 5 years of age. Most of them 84
(89%) were receiving isoniazid preventive therapy at the time of screening. Thirty seven out of 216 children had TB-related symptoms. Only 4
(10.8%) were clinically diagnosed with TB; and none had bacteriologically confirmed tuberculosis. CONCLUSION: The use of Xpert MTB/RIF assay
did not contribute to bacteriological confirmation of active TB in child contacts in this study. The low prevalence of tuberculosis in child contacts in
this study may reflect the high coverage of preventive therapy in young (<5 years) child contacts. The low sensitivity of Xpert MTB/RIF assay in
contacts may also suggest likely reflection of paucibacillary disease.
Description
Keywords
Pulmonary tuberculosis, Child, Contact screening, Xpert MTB/RIF assay, Gastric lavage
Citation
Birungi, F.M. et al. (2018). Xpert MTB/RIF assay did not improve diagnosis of pulmonary tuberculosis among child contacts in Rwanda. Pan African Medical Journal, 30(39).