Evaluation of Xpert® MTB/RIF and Ustar EasyNAT™ TB IAD for diagnosis of tuberculous lymphadenitis of children in Tanzania: a prospective descriptive study

BMC Infectious Diseases

Research Article

Hassan Chande¹  Mohamed Sasamalo²  Edward Masika³  Neema Kapalata³  Hans-Peter Beck⁴  Tracy R. Glass⁴  Maira Bholla⁵  Levan Jugheli⁵  Klaus Reither⁵ 

[1] Department of Histopathology, Muhimbili University of Health and Allied Sciences, P.O. Box 65000, Dar es Salaam, Tanzania;The Aga Khan Hospital, P.O. Box 2289, Dar es Salaam, Tanzania;Ifakara Health Institute, P.O. Box 74, Bagamoyo, Tanzania;National TB and Leprosy Clinic, Temeke District Hospital, P.O. Box 45232, Dar es Salaam, Tanzania;Swiss Tropical and Public Health Institute, Socinstrasse 57, 4002, Basel, Switzerland;University of Basel, Petersplatz 1, 4001, Basel, Switzerland;Swiss Tropical and Public Health Institute, Socinstrasse 57, 4002, Basel, Switzerland;University of Basel, Petersplatz 1, 4001, Basel, Switzerland;Ifakara Health Institute, P.O. Box 74, Bagamoyo, Tanzania;

关键词: Mycobacterium tuberculosis;    Lymphadenitis;    Childhood;    Fine needle aspiration;    Nucleic acid amplification;    Xpert MTB/RIF;    Ustar EasyNAT;    Culture;    Cytology;    Ziehl-Neelsen;   

DOI  :  10.1186/s12879-016-1578-z

 received in 2015-08-19, accepted in 2016-05-20,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundFine needle aspiration biopsy has become a standard approach for diagnosis of peripheral tuberculous lymphadenitis. The aim of this study was to compare the performance of Xpert MTB/RIF and Ustar EasyNAT TB IAD nucleic acid amplification assays, against acid-fast bacilli microscopy, cytology and mycobacterial culture for the diagnosis of TB lymphadenitis in children from a TB-endemic setting in Tanzania.MethodsChildren of 8 weeks to 16 years of age, suspected of having TB lymphadenitis, were recruited at a district hospital in Tanzania. Fine needle aspirates of lymph nodes were analysed using acid-fast bacilli microscopy, liquid TB culture, cytology, Xpert MTB/RIF and EasyNAT. Latent class analysis and comparison against a composite reference standard comprising “culture and/or cytology” was done, to assess the performance of Xpert MTB/RIF and EasyNAT for the diagnosis of TB lymphadenitis.ResultsSeventy-nine children were recruited; 4 were excluded from analysis. Against a composite reference standard of culture and/or cytology, Xpert MTB/RIF and EasyNAT had a sensitivity and specificity of 58 % and 93 %; and 19 % and 100 % respectively. Relative to latent class definitions, cytology had a sensitivity of 100 % and specificity of 94.7 %.ConclusionsCombining clinical assessment, cytology and Xpert MTB/RIF may allow for a rapid and accurate diagnosis of childhood TB lymphadenitis. Larger diagnostic evaluation studies are recommended to validate these findings and on Xpert MTB/RIF to assess its use as a solitary initial test for TB lymphadenitis in children.

【 授权许可】

CC BY   
© The Author(s). 2016