Diagnostic Performance of GeneXpert MTB/RIF for Pulmonary and Extra-Pulmonary Tuberculosis in Morocco.

<p>This study assesses the performance of the GeneXpert MTB/RIF® test (Cepheid Inc., Sunnyvale, CA, USA) for detecting Mycobacterium tuberculosis and Rifampicin resistance (RR) in Morocco, in comparison with conventional methods such as culture, and contrasts the results with data from other African countries. Conducted over 36 months, the study analysed 4,465 biological samples from patients suspected of tuberculosis at Ibn Sina University Hospital in Rabat between January 2020 and January 2023. The positivity rates for smear microscopy, GeneXpert, and culture were 2.55% (n = 114), 14.49% (n = 647), and 3.27% (n = 146), respectively. Of all samples, 71.41% were negative for both tests, 11.97% were culture-positive but smear-negative, and 10.59% were positive for both. GeneXpert achieved a sensitivity of 92.45%, specificity of 89.06%, negative predictive value of 99.99%, and positive predictive value of 24.48%. Rifampicin resistance was detected in 2.94% (19 samples, including 17 sputum and two cerebrospinal fluid samples). This study emphasizes the value of GeneXpert as a rapid and reliable diagnostic tool for tuberculosis and resistance detection in high-burden contexts, with potential for broad application in developing countries.</p>