吉布提Peltier总医院疑似肺结核住院患者结核分枝杆菌镜检与分子检的一致性

Souad Youssouf Kani Elmi, Maad Nasser Mohamed, Houssein Yonis Arreh, Mohamed Ali Mohamed
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摘要

背景:结核病仍然是一个重大的公共卫生问题,吉布提仍然是结核病负担高的国家之一,预计2020年的发病率为每10万人224例。目的:比较Ziehl-Neelsen (ZN)染色直接涂片镜检与GeneXpert (Xpert MTB/RIF法)作为诊断疑似肺结核(PTB)的金标准。材料和方法:对2022年3月至7月在Peltier综合医院住院的患者进行了一项基于卫生机构的横断面研究。对疑似结核病患者采集的153份样本(包括支气管肺泡灌洗液(BAL)和痰液)进行检测。结果:153份GeneXpert和ZN涂片镜检出29份(19.0%),ZN涂片镜检出23份(15.0%)。ZN涂片镜检的敏感性、特异性、阳性预测值(PPV)和阴性预测值(NPV)分别为79.31%、100%、100%和95.38%。结论:本研究得出ZN涂片检测肺结核的敏感性稍差;因此,我们继续建议在可能的情况下进行GeneXpert检测,以防止受影响者长期发病,并防止因错过涂片阴性肺结核的诊断而造成的直接和间接损失。
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Concordance between microscopic and molecular detection of Mycobacterium tuberculosis in hospitalized patients with suspected pulmonary tuberculosis in Peltier General Hospital, Djibouti
Background: Tuberculosis (TB) remains a significant public health issue, and Djibouti is still one of the nations with a high TB burden, with a forecasted incidence rate of 224 cases per 100,000 people in 2020. Objectives: To compare the Ziehl-Neelsen (ZN) stain direct smear microscopy with the GeneXpert (Xpert MTB/RIF assay) as the gold standard for diagnosing patients with suspected pulmonary tuberculosis (PTB). Material and method: A health facility-based cross-sectional study was conducted on hospitalized patients at Peltier General Hospital from March to July 2022. A total of 153 samples (including bronchoalveolar lavage (BAL) and sputum) collected from presumptive TB patients were tested. Results: Out of the 153 samples analyzed by GeneXpert and ZN smear microscopy, 29 (19.0%) were detected by GeneXpert and 23 (15.0%) were positive by ZN smear microscopy. ZN smear microscopy had sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) that were 79.31%, 100%, 100%, and 95.38%, respectively. Conclusion: This study concluded that ZN smear had a slightly poor sensitivity for determining the presence of PTB; consequently, we continue to advise GeneXpert testing whenever it is possible to prevent prolonged morbidity in those affected and to prevent the direct as well as indirect expenses of missing the diagnosis of smear-negative PTB.
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