Diagnostic Efficacy Of Gene X-Pert/ MTB-RIF Assay And Its Implication For The Treatment Of MDR TB In Rural Medical College

2016-11-03T03-51-08Z
Source: National Journal of Integrated Research in Medicine
B.B.Bhadke*, R.K.Rathod**, D.G.Deshmukh***, A.B.Luniya****, P.A.Bulle*****, A.V.Surjushe******.
Aims and objectives: To diagnose and treat the MDR Tuberculosis by XPERT MTB/RIF assay as early as possible so that transmission of infection can be minimized and To find out prevalence of MDR TB in our rural district of Maharashtra. Methods: This is a observational ,prospective study conducted over a period of 14 months ( Jan 15 to April 16 ) in the Dept. of Pulmonary Medicine, Shri Vasantrao Naik Gov.t Medical College, Yavatmal, Maharashtra. We have subjected 613 patients who fulfill the clinical criteria for RNTCP - MDRTB suspect 1.Treatment failure. 2. Retreatment case sputum positive at the end of 4 months, 3.Contact of known MDRTB case, 4.Sputum positive at diagnosis, retreatment case, 5. Any follow up sputum positive, 6.Other category (sputum negative retreatment cases), and 7. HIV-TB Cases. We have excluded all new cases (sputum positive, sputum negative and extrapulmonary cases ). With all precautions two sputum samples collected in the designated microscopy centre. One sample was subjected for routine ZN staining and other one for GENE X-PERT MTB/RIF assay. Result. Out of 613 MDR suspect subjects, 314 (51.23%) were found in the age group 30 to 50 which is economically productive age group. There were 428 (69.82%) male and 185 (30.18%) female. Out of total study patient 44 (7.18 %) were detected Rifampicin resistance by X-PERT MTB/RIF assay. Amongst MDR suspect criteria highest no (4.07 %) of Rifampicin resistant were found in Retreatment cases ( group 4 ) followed by 1.47 % in any follow up sputum positive ( group 5 ) , 0.65 % in sputum negative retreatment cases ( group 6), 0.32 % in treatment failure ( group 1 ) , 0.49 % in HIV TB cases (group7 and0.16 % in contacts of known MDR ( group 3) .There were 144 ( 23 .5 ) were co infected with HIV.TB. Conclusion: We conclude that GENE XPERT MTB /RIF assay has significant role in detecting Rifampicin resistance, patient can be started on treatment at the earliest thereby reducing morbidity, progression to XDR, mortality and transmission of MDR/XDR TB in the community can be minimized. However it has some shortcomings that it cannot detect resistance of other anti- tubercular drugs and atypical mycobacteria.[B.B.Bhadke NJIRM 2016; 7(5):33-39]


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