Sohail Khan Raja, Raza Ullah, Syed Wasib Shah, Shumaila Ambreen, Haleema, Maria Habib.
Comparative Sensitivity of Smear Microscopy for AFB versus Gene Xpert/Rif Assay on Endobronchial washings of the Sputum Smear Negative/Sputum Scarce patients with suspected Pulmonary Tuberculosis.
Pak J Chest Med Jan ;26(4):201-4.

Background: Pulmonary Tuberculosis (PTB) is a highly prevalent infectious disease. It can be diagnosed with various tests including sputum ZN staining, Gene Xpert and culture. Objectives: Objective of this study is to determine the sensitivity of smear microscopy (SM) for AFB and Gene Xpert MTB/RIF assay in diagnosing PTB in sputum negative and sputum scarce patients on endobronchial washings in comparison to culture for mycobacterium. Methodology: This Cross Sectional Study was conducted at Pulmonology department, Military Hospital Rawalpindi (MH-Rawalpindi). Patients of both gender, aged 18-70 years and sputum smear negative PTB suspects were included in the study. Diagnosed or already on anti-tuberculous treatment patients and Imunocompromised patients (HIV) were excluded. Endobronchial washings were collected from affected segment from all patients using fiber-optic bronchoscopy. Specimen was divided into 3 parts. Each was sent for ZN-microscopy for AFB, MTB gene Xpert and culture. Data was analyzed in SPSS version-20. Frequency and percentages were calculated for qualitative variables like gender, sensitivity of SM for AFB/Gene Xpert. Mean +- standard deviation was calculated for quantitative variables like age, duration of illness. Post stratification Chi-square test was applied. Results: Mean age was 45.75+-17.73 years. 248(74.5%) were male and 85(25.5%) female. Sensitivity and Specificity of BAL smear microscopy was 75.44% and 86.59% while that of Gene XPERT was 94.74% and 80.43% respectively. Conclusion: Results of this study showed that Gene Xpert is more accurate than BAL smear microscopy in predicting PTB.

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