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Evaluation of Xpert® MTB/RIF and Ustar EasyNAT™ TB IAD for Diagnosis of Tuberculous Lymphadenitis of Children in Tanzania: A Prospective Descriptive Study

Bholla, M., Kapalata, N., Masika, E., Chande, H., Jugheli, L., Sasamalo, M., Glass, T. R., Beck, H.-P. and Reither, K. (2016) 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. ISSN 1471-2334

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Abstract

Fine 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. Children 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. Seventy-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 %. Combining 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.

Item Type: Article
Keywords: Mycobacterium tuberculosis, Lymphadenitis, Childhood, Fine needle aspiration, Nucleic acidampl ification, Xpert MTB/RIF, Ustar EasyNAT, Culture, Cytology, Ziehl-Neelsen
Subjects: Tuberculosis > Drug-resistant TB
Divisions: Ifakara Health Institute > Biomedical
Depositing User: Mr Joseph Madata
Date Deposited: 27 Jun 2016 05:36
Last Modified: 27 Jun 2016 05:36
URI: http://ihi.eprints.org/id/eprint/3798

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