Results of the performance of automated GeneXpert in childhood tuberculosis in Addis Ababa, Ethiopia: a retrospective cross-sectional study

Abstract

Background: Approximately 81% of all childhood tuberculosis cases occur among 22 high-burden countries and Ethiopia ranks eighth among these high burden countries. The GeneXpert Mycobacterium tuberculosis DNA and resistance to rifampicin (MTB/RIF) test can detect pediatric tuberculosis and its multidrug-resistant form with very high sensitivity and specificity, but limited data exists on its use in our country. We aimed to evaluate the effectiveness of the GeneXpert assay in comparison to children with a clinical diagnosis of Tuberculosis. 
 Methods: A descriptive retrospective study on 144 TB-diagnosed children younger than 15 years was conducted at Tikur-Anbessa specialized hospital and Yekatit 12-referral hospital, pediatrics departments, Addis Ababa, Ethiopia. The performance of the GeneXpert test was evaluated by re-vising the charts of patients who have begun anti-tuberculosis treatment. We extracted information from the chart review of 144 eligible children who were diagnosed with tuberculosis and began anti-TB treatment from February 2014 to July 2016. 
 Result: In the study, 144 patients with clinical diagnosis of tuberculosis were included, and 23% of them also had concurrent HIV infection. Equal numbers of male and female were present; 48.6% were from Addis Ababa. Thirty-four patients (23.6%) were missing their childhood vaccinations. The GeneXpert assay detected disease in only 24 (16.7%) of clinically diagnosed pediatric tuberculosis patients.
 Conclusion: Although the GeneXpert assay is helpful in the diagnosis of pediatric tuberculosis, most patients were still receiving treatment even after a negative GeneXpert test, necessitating the need for a more sensitive test.