Positivity Proportion of Xpert MTB/RIF in Suspected Pediatric Pulmonary Tuberculosis Patients at Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
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Highlights:
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This study utilized Xpert MTB/RIF result data from children using both sputum and gastric lavage specimens, which is different from previous studies that relied solely on sputum specimens.
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“Mycobacterium tuberculosis not detected” was the most common result on the Xpert MTB/RIF examination in suspected pediatric TB cases.
Abstract
Introduction: The difficulty of diagnosing tuberculosis (TB) is the most significant challenge in pediatric pulmonary TB cases. More accurate and faster diagnostic tools are essential for detecting TB infections, enabling the implementation of appropriate therapy and treatment management more effectively and promptly. This study aimed to determine the proportion of positive results using the Xpert Mycobacterium tuberculosis/rifampicin (MTB/RIF) assay as a rapid molecular method in suspected pediatric pulmonary TB patients at Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.
Methods: This study employed a descriptive-retrospective design, utilizing data obtained from medical records. The total number of samples included in this study was 373 samples (n=373). The data was analyzed using the International Business Machines Corporation (IBM) Statistical Package for the Social Sciences (SPSS) version 26.0 for Windows.
Results: The most commonly used specimen from pediatric TB patients in the Xpert MTB/RIF examination was sputum, accounting for 59.2%. The most common result from the Xpert MTB/RIF examination was “MTB not detected,” with a prevalence of 88.2%.
Conclusion: The most commonly used specimen for the Xpert MTB/RIF examination of pediatric pulmonary TB was sputum. The majority of results found with the Xpert MTB/RIF examination were “MTB not detected” both in sputum and gastric aspirate specimens.
World Health Organization (WHO). Global Tuberculosis Report 2021. Geneva, (2021). [Website]
World Health Organization (WHO). Global Tuberculosis Report 2023. Geneva, (2023). [Website]
United Nations Children's Fund (UNICEF) Indonesia. Towards a Future in Indonesia without Child Undernutrition. Jakarta, (2024). [Website]
The Health Development Policy Agency (Badan Kebijakan Pembangunan Kesehatan). Laporan Tematik Survei Kesehatan Indonesia Tahun 2023. Jakarta, (2024). [Website]
Harits M, Widjaja NA, Ardiana M. Profile of Metabolic Syndrome Components in Obese Adolescents: Stunting vs. Non-Stunting. Indones J Public Heal 2024; 19: 302–315. [Journal]
Rarome BB, Aisah N, Setyoningrum RA, Mertaniasih NM. GeneXpert MTB/RIF and Mycobacterium tuberculosis Sputum Culture in Establishing the Diagnosis of Pulmonary Tuberculosis and Rifampicin Resistance in Suspected Childhood Pulmonary Tuberculosis in Soetomo Hospital. Indones J Trop Infect Dis 2020; 8: 152–160. [Journal]
Utomo B, Chan CK, Mertaniasih NM, Soedarsono S, Fauziyah S, Sucipto TH, et al. Comparison Epidemiology between Tuberculosis and COVID-19 in East Java Province, Indonesia: An Analysis of Regional Surveillance Data in 2020. Trop Med Infect Dis; 7. 2022. [PubMed]
Mertaniasih NM, Soedarsono, Kusmiati T, Koendhori EB, Kusumaningrum D, Koesprijani K, et al. Difficulties with the Implemented Xpert MTB/RIF for Determining Diagnosis of Pulmonary and Extrapulmonary Tuberculosis in Adults and Children. J Clin Tuberc Other Mycobact Dis 2020; 19: 100159. [PubMed]
Centers for Disease Control and Prevention (CDC). Core Curriculum on Tuberculosis: What the Clinician Should Know. CDC, (2024). [Website]
Kaswala C, Schmiedel Y, Kundu D, George MM, Dayanand D, Devasagayam E, et al. Accuracy of Xpert MTB/RIF Ultra for the Diagnosis of Tuberculosis in Adult Patients: A Retrospective Cohort Study. Int J Infect Dis 2022; 122: 566–568. [PubMed]
World Health Organization (WHO). WHO TB Knowledge Sharing Platform. Geneva, (2022). [Website]
Park JH, Choe J, Bae M, Choi S, Jung KH, Kim MJ, et al. Clinical Characteristics and Radiologic Features of Immunocompromised Patients with Pauci-Bacillary Pulmonary Tuberculosis Receiving Delayed Diagnosis and Treatment. Open Forum Infect Dis 2019; 6: ofz002. [PubMed]
Triasih R, Setyati A, Setyowireni D, Nuryastuti T, Putri RDI, Rusdiyati E. Use of Xpert MTB/RIF for Diagnosis of Pediatric Tuberculosis in Indonesia. Paediatr Indones 2020; 60: 198–204. [Journal]
Gates B, Allen P. Excel, (2019). [Website]
Nie NH, Bent DH, Hull CH. Statistical Package for the Social Sciences (SPSS), (2017). [Website]
Wardhani ANK, Setyoningrum RA. Profile of Xpert MTB/RIF in Children with Suspected Tuberculosis in Tertiary Hospital in Surabaya, Indonesia. Acta Sci Paediatr 2022; 5: 21–26. [Journal]
Pediatric TB Operational and Sustainability Expertise Exchange (POSEE) Taskforce. Summary Guidance for Microbiological and Clinical Diagnosis of Pulmonary Tuberculosis among Children, (2021). [Website]
Moore BK, Graham SM, Nandakumar S, Doyle J, Maloney SA. Pediatric Tuberculosis: A Review of Evidence-Based Best Practices for Clinicians and Health Care Providers. Pathog (Basel, Switzerland); 13. 2024. [PubMed]
Walusimbi S, Bwanga F, De Costa A, Haile M, Joloba M, Hoffner S. Meta-Analysis to Compare the Accuracy of GeneXpert, MODS and the WHO 2007 Algorithm for Diagnosis of Smear-Negative Pulmonary Tuberculosis. BMC Infect Dis 2013; 13: 507. [Journal]
Pierre-Louis MH, Rouzier V, Rivera V, Systrom HK, Julma P, Jean E, et al. Diagnosis of Tuberculosis Using Gastric Aspirates in Pediatric Patients in Haiti. J Pediatric Infect Dis Soc 2021; 10: 22–26. [PubMed]
Schaaf HS, Marais BJ. The Role of Xpert MTB/RIF Ultra in Diagnosing Pulmonary Tuberculosis in Children. American Journal of Respiratory and Critical Care Medicine 2019; 200: 1464–1465. [PubMed]
Firnadi LPP, Setyoningrum RA, Suwandi MYS. Profile of Tuberculosis in Children and Adolescent at Dr. Soetomo General Hospital Surabaya. JUXTA J Ilm Mhs Kedokt Univ Airlangga 2022; 13: 42–45. [Journal]
Ananto MA, Setyoningrum RA, Lestari P. Prevalence and Risk Factors of Latent Tuberculosis Infection (LTBI) at Madura Boarding School as a High-Risk Congregate Setting. JUXTA J Ilm Mhs Kedokt Univ Airlangga 2024; 15: 76–82. [Journal]
Oktaviani RD, Lestari P, Maranatha D, Setyoningrum RA. Profile of Tuberculosis in Children in Taman District, Sidoarjo Regency, Indonesia. Folia Medica Indones 2022; 58: 15–20. [Journal]
Mendes CC, Unger RJG, de Araújo-Jorge TC, Carvalho ACC. Tuberculosis in Adolescence: An Integrative Review Focusing on Patient-Centered Care. Revista Paulista de Pediatria; 42. 2024. [NCBI]
Diallo K, Diatta A, Wembulua BS, Camara A, Sarr H, Coly MN, et al. Performance of GeneXpert in the Diagnosis of Tuberculosis in a Decentralized Area: Example of Hopital De La Paix, in Ziguinchor, Southern Senegal from 2016 to 2018. Int J Trop Dis; 5. 17 March 2022. [Journal]
Soetrisno ARP, Setiabudi RJ, Wulandari L. Profile of Pulmonary Tuberculosis Patients with Type 2 Diabetes Mellitus in Pulmonary Department Dr. Soetomo General Hospital Surabaya. J Respirasi 2020; 6: 35–39. [Journal]
World Health Organization (WHO). WHO Consolidated Guidelines on Tuberculosis: Module 4: Treatment: Drug-Susceptible Tuberculosis Treatment. Geneva, (2022). [Website]
Ainan S, Furia FF, Mhimbira F, Mnyambwa NP, Mgina N, Zumla A, et al. Xpert® MTB/RIF Assay Testing on Stool for the Diagnosis of Paediatric Pulmonary TB in Tanzania. Public Heal Action 2021; 11: 75–79. [PubMed]
Costa-Lima JF da, Pimentel LMLM, Santos FCF, Salazar MP, Duarte RS, Mello FC de Q, et al. Rapid Detection of Mycobacterium tuberculosis in Children Using Blood and Urine Specimens. Rev Soc Bras Med Trop 2020; 53: e20200051. [PubMed]
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