Evaluation of Cepheid's Xpert MTB/RIF Test on Pleural Fluid in the Diagnosis of Pleural Tuberculosis in a High Prevalence HIV/TB Setting

摘要: Background Diagnosis of pleural tuberculosis (TB) using routinely available diagnostic methods is challenging due to the paucibacillary nature disease. Histopathology and tissue TB culture involves an invasive procedure which requires expertise appropriate equipment, both often unavailable in many health units. Xpert MTB/Rif test has been widely evaluated sputum specimens but data on its performance scarce. We accuracy Cepheid's fluid diagnosis Uganda. Methods Consenting adult patients with exudative effusions underwent biopsy obtained subjected Lowenstein-Jensen mycobacterial growth indicator tube MTB cultures histopathology. Pleural for testing was also collected. Data socio-demographic characteristics, clinical symptoms, HIV status CD4 count were Sensitivity, specificity, positive negative predictive values calculated and/or histopathology as reference standard. Results Of 116 participants [female 50%, mean age 34 (SD ±13], 87/116 (75%) had confirmed The identified 25 (28.7%) 87 cases. sensitivity specificity 28.7% 96.6% respectively while 96.1% 31.1% respectively. Conclusion Xpert does not accurately diagnose therefore cannot be used initial evaluation suspected TB. New, rapid accurate tests are still warranted.