Near Point-of-care and Utilisation of Decentralised GeneXpert MTB/RIF for PTB Diagnosis and PTB/HIV Co-infection Prevalence in a Resource Constrained Rural Community Hospital in Nigeria

Even in rural communities of developing nations where resources are constrained, GeneXpert MTB/RIF technology is fast becoming a potent tool for near-instant diagnosis of PTB. The objective is to assess utilization of near point-of-care of GeneXpert MTB/RIF technology, PTB and HIV burden after sero-conversion among presumptive PTB patients. This was a retrospective study from April, 2015 to November, 2016 at Abwa-Mbagen. Data for PTB and HIV was from laboratory registers based on sputum GeneXpert MTB/RIF technology and Determine/Stat pak respectively. Sputum specimens for the 1,374 presumptive PTB cases recruited were all analysed using the decentralised GeneXpert machine. There were more females 759 (55.2%) than males 615 (44.8%) with mean age of 38.2 years (SD=15.49 years). About 210 (15.7%) patients tested positive for PTB with males more vulnerable (Male: Female; 2:1). Out of 829 patients who tested positive to HIV, females were more (525; 63.33%) than their male counterparts (304; 36.67%) while PTB/HIV co-infection rate was observed to be 88 (6.4%) with males most vulnerable. The positivity for PTB, HIV and co-infection was skewed to the late reproductive age group of 31-40 years: GeneXpert MTB/RIF sputum positive PTB 210 (15.3%); χ2 = 9.060, df = 8, P = 0.337, HIV 829 (60.3%); χ2 = 95.365, df = 8, P = 0.000 and GeneXpert sputum positive PTB/HIV co-infection 88 (6.4%); χ2 = 16.558, df = 8, P = 0.035.The utility of near point-of-care GeneXpert for diagnosis of PTB was total with a corresponding high prevalence of PTB, HIV and co-infection among the presumptive PTB patients with vulnerable age group of 31-40 years.