Background: Case detection of pulmonary tuberculosis (PTB) is a challenge, even if different diagnostic methods used. Nowadays, it is improved, after the advancement of the detection method such as Gene Xpert assay a prodigious change for the adult. But in the pediatric PTB is a still a challenge, due to the lack of well-developed physiological capacity. Young children are unable to produce enough amount of sputum to be detected by the Gene Xpert. So, a substantial number of children are not diagnosed and fail to get treatment.

Objective: To evaluate Gene Xpert in detecting PTB from the stool and sputum samples from TB suspected children against the gold standard sputum culture method in Adama Hospital Medical College (AHMC), Adama, Ethiopia from Jan 1, 2017, to June 30, 2018.

Methods: A cross-sectional study design was used, to evaluate 422 Stool and sputum sample was collected from PTB suspected children (<15 years) by consecutive sampling technique. Both stool and sputum specimens were run in the Gen Xpert at AHMC and sputum specimens were cultured using LJ culture medium at Oromia Regional Laboratory, Adama, Ethiopia. Specimen processing and testing were done in accordance with the standard mycobacterial safety precautions, procedures, and manufacturers instruction. Descriptive statistical analysis was done by SPSS version 20, a chi-square test was used to show their association at 95 % CI and P-value <0.05 was considered statistically significant, sensitivity, specificity, PPV and NPV of the tests were also calculated. The study was commenced after obtaining ethical approval and permission letter from respective bodies. All data obtained from the participants kept confidentially.

Result: A total of 422 children were enrolled. About, 70% were living in an urban area. Male to female proportion was 203/219.  The mean age was 10.8 yrs, the majority (71.8%) of the participant age was >=5 yrs old. From 422 children investigated, 26 had been detected for PTB and 24 of them are confirmed by the sputum culture, with three invalid and four errors. Two of those PTB detected were rifampicin resistant. Stool Gene Expert had a sensitivity, specificity, PPV and NPV (96%, 99.5%, 92.3%, 99.7%) respectively.

Conclusion and Recommendation: the sensitivity of Gene expert to detected MTB in stool sample was higher as 96 % (P=.000). Therefore, stool can be used as an alternative sample for the diagnosis of PTB using gene Expert assay for children unable to give respiratory samples.

Keywords: Gene Expert, Mycobacterium tuberculosis, Pulmonary Tuberculosis, Children.

Contact Person: Teklu Shiferaw (BSc, MSc, Asst Prof.)

Mobile: 09 1710 2005  Email: teklucfan@gmail.com