Comparative Evaluation of GeneXpert and Chest Xrayin Diagnosing Paediatric Tuberculosis at Arthur Davison Children's Hospital, Zambia

Abstract

Introduction

Tuberculosis (TB) remains a major global health issue, affecting 10-20% of children worldwide. Zambia is one of the 30 high-burden TB countries. Diagnosing Mycobacterium tuberculosis in children is particularly challenging. Early detection and treatment are crucial for effective management and preventing severe disease progression. This study aimed to assess TB prevalence in children at Arthur Davison Children's Hospital in Ndola, Zambia, using GeneXpert on gastric lavage samples and X-ray imaging.

Method

This was a cross-sectional study conducted at Arthur Davison Children’s Hospital from October 2021 to February 2022. Children aged 0 to 10 years with suspected presumptive tuberculosis were enrolled for diagnostic evaluation. Tuberculosis diagnosis was performed using the GeneXpert polymerase chain reaction analyzer on gastric lavage samples, compared with findings from chest X-ray imaging. Data analysis was carried out using descriptive statistics in the Statistical Package for Social Sciences (SPSS) version 22, with statistical significance set at p < 0.05.

Results

Out of the 138 participants enrolled, the prevalence of tuberculosis was 13.8% based on X-ray imaging and 1.4% using the GeneXpert analyzer. Males had a higher prevalence of tuberculosis (52.6%) compared to females (47.4%). The age group of participants who were mostly affected was 0-4 years (68.4%). The agreement between the two diagnostic methods, measured by Cohen's Kappa Coefficient, was 0, indicating no agreement. The p-value for the comparison was 1.19.

Conclusion

The findings of this study highlight significant presence of tuberculosis among children under 10 years of age at Arthur Davison Children’s Hospital. However, there was no agreement between the diagnostic methods used, namely GeneXpert and X-ray imaging. Further comprehensive studies are recommended to investigate the potential for false positives associated with X-ray imaging or false negatives on the GeneXpert analyzer.