The GeneXpert Test for The Diagnosis of Childhood Pulmonary Tuberculosis in Suspected Cases: Study in a Tertiary Care Hospital in Bangladesh

Background: Pulmonary tuberculosis (PTB) remains a significant health issue in children. Early and accurate diagnosis is critical but challenging, The GeneXpert test, a rapid and accurate molecular diagnostic tool, has improved TB detection by identifying Mycobacterium tuberculosis and resistance to rifampicin within hours. Aim of the study: This study aimed to assess the role of the GeneXpert test in diagnosing pulmonary tuberculosis in clinically suspected pediatric cases. Methods: This cross-sectional observational study was conducted in the department of pediatrics, Sir Salimullah Medical College Mitford Hospital, Dhaka, Bangladesh from March 2021 to August 2022. In this study, 280 pediatric cases, all under 12 years old and clinically suspected, were enrolled using purposive sampling. Diagnostic tests, including chest X-ray, Mantoux test, microscopy of sputum or gastric aspirate, and GeneXpert, were conducted to validate the clinical diagnoses. Data analysis was carried out using the SPSS version 23.0 program. Results: In our study, the GeneXpert test demonstrated high sensitivity (96.79%), effectively identifying true positives, but had moderate specificity (51.61%), resulting in more false positives. The positive predictive value was 71.56%, and the negative predictive value was 92.75%, indicating higher accuracy in correctly identifying true negatives. Overall, the test achieved an accuracy of 76.79%, showing it reliably determined the disease status in most cases. Conclusion: GeneXpert test is an effective diagnostic procedure for detecting pulmonary tuberculosis in clinically suspected pediatric patients. It shows high sensitivity and moderate specificity in diagnosing pulmonary tuberculosis in clinically suspected or presumptive pediatric cases.