Contribution Of Genexpert MTB/RIF To The Diagnosis Of Pleuropulmonary Tuberculosis.

Background: Tuberculosis (TB), a transmissible disease caused by Mycobacterium tuberculosis, remains a major public health problem with nearly 8 million new cases each year and more than 1 million deaths per year.The WHO recommends the use of rapid molecular tests for the initial diagnosis of all people presenting signs and symptoms of tuberculosis.These tests are highly reliable and will enable considerable progress to be made in the early detection of cases of tuberculosis and drug-resistant tuberculosis.Aims: Our study aimed to evaluate the contribution of the Xpert MTB/RIF test in the diagnosis of pleuropulmonary tuberculosis at Kamenge University Hospital (CHUK).Methods: This was a retrospective descriptive and analytical study conducted from 1 March 2018 to 31 December 2021 in the Mycobacteriology Department of the Kamenge University Hospital in Bujumbura.All pleuropulmonary specimens for which an Xpert MTB/RIF test was requested were included in the study, regardless of the patient's age.Results: During the study period, 577 patients suspected of having pleuropulmonary tuberculosis underwent an Xpert MTB/RIF test, of whom 130, or 22.53%, were positive.The majority of patients were men, with a sex ratio of 1.2.The average age was 40.4,with extremes of 1 and 95.The most represented age group was 20 to 40, with a percentage of 40.3%.The vast majority of samples were sputum (85.10%).Direct microscopy was positive in 80 cases out of 498 samples, i.e., a detection rate of 16.06%, whereas the Xpert MTB/RIF test had a detection rate of 25.5% on samples that had undergone both direct microscopy and the Xpert MTB/RIF test.Out of the 130 strains of Mycobacterium tuberculosis detected, 2 were resistant to rifampicin (1.54%).Most of our samples showed a positive Xpert MTB/RIF test at medium intensity, i.e., a total of 50 (38.46%).The Xpert MTB/RIF positivity rate was higher in samples of pulmonary origin. Conclusion:The Xpert MTB/RIF test performed significantly better than direct microscopy in detecting pleuropulmonary tuberculosis.It would therefore be reasonable to make it more accessible in the country's various laboratories.