Contribution of Gene Xpert MTB/RIF and epidemiology in the diagnosis of pulmonary tuberculosis in PLWHIV seen at the Ignace Deen National Hospital in Conakry

Abstract

Introduction: Tuberculosis and HIV are real public health problems in the world and mainly in Africa. The current challenge is to be able to diagnose TB in all PLWHA, hence the interest in evaluating the effectiveness of GeneXpert MTB/RIF in the diagnosis of pulmonary TB. Method: This is a prospective cross-sectional and descriptive study of HIV-positive patients who came for consultation during the survey period which lasted six months, from 1 February to 7 August 2021, at the Ignace Deen National Hospital in Conakry and at the Gamal Abdel Nasser University in Conakry. Data were collected and analysed using Epi-info version 7.0, Pack Office 2013 (Word, Excel and Power point). Results: Out of 402 patients received, we recorded 112 positive cases, i.e. 28% and 290 negative cases, i.e. 72%. Fluorescence microscopy gave 16% and Ziehl-Neelsen microscopy gave 14% with sensitivities of 90%, 47% and 43% respectively. 104 sample patients were sensitive to Rifampicin, i.e. 92.86% against 08 cases of resistance, i.e. 7.14%. The male sex is more represented with 53% against 47% for the female sex. All the communes of Conakry were concerned, but the communes of Matoto and Ratoma were the most represented, respectively 31% and 23%. Patients from outside Conakry had a rate of 21%, the communes of Matam 11% and Dixinn 9%. Patients from the Commune of Kaloum were the least represented with 5%. Almost all socio-professional groups are affected. Commercial agents are the most represented with 31%, followed by workers with 22%, housewives with 15%, drivers with 10%, administrative agents with 9%, pupils/students with 7% and security agents with 6%. Also all age groups are affected by HIV-TB co-infection but with the highest prevalence in the 21 to 40 age group with 56% followed by the 41 to 60 age group with 30%. The age groups least affected are those under 20 and over 60 years of age, respectively 9% and 5%. Conclusion: The present study confirms a significantly higher validity of GeneXpert MTB/RIF than microscopy in the detection of TB and its place in the prediction of multidrug resistance. Its systematic use coupled with microscopy would allow better control of tuberculosis in HIV-infected individuals.