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  4. Evaluation of Xpert® MTB/RIF and ustar easyNATtm TB IAD for diagnosis of tuberculous lymphadenitis of children in Tanzania : a prospective descriptive study
 
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Evaluation of Xpert® MTB/RIF and ustar easyNATtm TB IAD for diagnosis of tuberculous lymphadenitis of children in Tanzania : a prospective descriptive study

Date Issued
2016-01-01
Author(s)
Bholla, Maira
Kapalata, Neema
Masika, Edward
Chande, Hassan
Jugheli, Levan
Sasamalo, Mohamed
Glass, Tracy R.  
Beck, Hans-Peter  
Reither, Klaus  
DOI
10.1186/s12879-016-1578-z
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.
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