Diagnosis of Multi-drug Resistant Tuberculosis Mutations Using Hain Line Probe Assay and GeneXpert: A Study Done in Zimbabwe
Journal Title: Journal of Advances in Medicine and Medical Research - Year 2015, Vol 5, Issue 8
Abstract
Background and Aims: Tuberculosis (TB) is a global public health problem and one of the leading causes of death. Worldwide, 31% of all estimated new TB cases are from Africa. Zimbabwe is one of the 22 high TB burden countries. Multi-drug resistant TB (MDR-TB) poses challenges in TB control, hence the need for rapid laboratory diagnosis of MDR-TB for optimal treatment and reducing spread. The study aim was to investigate genetic mutations associated with MDR-TB isolates from various Harare clinics using the GeneXpert MTB/RIF® by Cepheid and Genotype MTBDRplus, to improve the diagnosis and management of MDR-TB. Methods: Samples from adults aged 16 years and older, recruited from several polyclinics in the southern suburbs of Harare were used for our study. All laboratory tests prior to this study had been carried out at Biomedical research and training institute’s level three bio-safety TB laboratory from January 2008-August 2012. Ethical approval was sought from BRTI Institutional review board. A total of 69 (37 MDR-TB and 32 non MDR-TB) archived isolates processed on Genotype MTBDRplus (Hains) and corresponding 39 sputum were processed on the GeneXpert. Mutations on rpoB, katG and inhA genes were observed. The gold standard was culture. Diagnostic accuracy of both methods and their level of agreement were calculated. Results: Of the 37/69 isolates screened by culture for MDR-TB, 88.4% were confirmed by MTBDR® plus line probe assay (Hains). Within the 39 isolates tested using the Xpert MTB/RIF (GeneXpert) assay 12 were true MDR-TB. Over 8 single nucleotide polymorphisms were observed on the three genes conferring Rifampicin and Isoniazide drug resistance. The Hains and GeneXpert had an almost perfect agreement with a kappa value of 0.82. Conclusion: Genetic markers can be used in the diagnosis of MDR-TB, to complement phenotypic methods such as culture. Using the commercial methods, Hains and GeneXpert, 88.4-94.2% of drug resistance maybe detected. Furthermore, we recommend sequencing so as to identify novel mutations and to design a kit that is custom made for the population.
Authors and Affiliations
S. Dube-Mandishora Racheal, Dhlamini Zephaniah, Mutetwa Reggie, Duri Kerina, Stray-Pedersen Babill, Mason Peter
Keywords
Related Articles
- EP ID EP347098
- DOI 10.9734/BJMMR/2015/13979
- Views 70
- Downloads 0
Early Detection of Cardiac Affection in Acute Carbon Monoxide Intoxicated Patients
Background and Objective: Cardiovascular sequelae of Carbon monoxide (CO) poisoning may be clinically occult and remains undiagnosed due to lack of overt symptoms as acute chest pain and ischemic changes in the ECG. The...
Concurrent Prediabetes and Prehypertension in a Rural Community in South East Nigeria
Aim: To determine the prevalence of concurrent prediabetes and prehypertension among apparently healthy adults in Ihuokpara, a rural community, South East Nigeria. Study Design: The study was cross-sectional. Place and...
Modal and Vibration Analysis of Functionally Graded Dental Implant
Dental implant is considered to be the best treatment when dealing with the loss of teeth. It gives beautiful results and can last longer than most of other treatments. Since the Osseo-integration period is a critical pe...
Clinical Profile and Factors Related to Compliance with Benzathine Penicillin G Prophylaxis among RF/RHD Patients at the Tarlac Provincial Hospital, Philippines
Rheumatic fever (RF) and Rheumatic heart disease (RHD), despite a documented decrease in their incidence, remain as problems in both industrialized and industrializing countries even at the beginning of the 21st century....
Knowledge of Primary Health Care Providers in Nairobi East District, Kenya, Regarding HIV-related Oral Facial and Other Common Oral Diseases and Conditions
Background: In the Kenya primary health care (PHC) setting where most patients, including nearly 1.4 million HIV-infected people, seek medical care, PHC providers are expected to identify and manage HIV-related oral dise...