Evaluation of culture, molecular assay (TB-PCR), GeneXpert system and histopathology for detection of genital tuberculosis


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Article type :

Original Article

Author :

Ritu Mahata, Subrata Das, Amrita Gupta

Volume :

12

Issue :

3

Abstract :

Background: Female genital tuberculosis (FGTB) has a crucial role in many gynaecological complaint and delay in diagnosis can cause irreversible damages. The new diagnostic technique GeneXpert system is accurate and rapid test can make paradigm shift in FGTB treatment. Aim & Objectives: The aim of the study to estimate efficacy of different tests i.e. AFB BACTEC culture, molecular assay (TB-PCR) and histopathology in comparison to GeneXpert system to detect FGTB. Materials and Methods: The prospective observational study was conducted in between January, 2018 and June, 2019. Randomly selected total 62 patients were put under all four diagnostic tests from endometrial sampling. The positivity of genital TB and efficacy of the tests were compared with test result of GeneXpert assay. Results: In our study, out of 62 patients, most commonly 33.9% were each from age group of 21-30 and 31-40 years i.e. reproductive ages, 45.2% were overweight, primary infertility of 48.4% patients were predominant symptomatology. Overall positivity by GeneXpert test was 21% (3/62), histopathology 8.1% (5/62), AFB BACTEC culture 12.9% (8/62) and 24.2% (15/62%) by molecular assay (TB-PCR). On evaluating against our diagnostic tests, specificity of histopathology, AFB BACTEC Culture and TB-PCR was 97.96%, 95.92% and 75.51%. The diagnostic tests were analysed by Kappa measure agreement in comparison to GeneXpert assay. The histopathology and AFB BACTEC Culture showed fair and moderate agreement respectively, but on the contrary TB-PCR have not showed any agreement with GeneXpert assay. Conclusion: High degree of suspicion and battery of tests needed for diagnosis of genital TB. Rapid diagnosis by GeneXpert assay may play a crucial role in TB control programme. Key Messages: Female genital tuberculosis (FGTB) has a crucial role in many gynaecological complaint and delay in diagnosis can cause irreversible damages. The new diagnostic technique GeneXpert system is accurate and rapid test can make paradigm shift in FGTB treatment.  

Keyword :

Genital tuberculosis, Histopathology, Polymerase chain reaction, Genexpert, AFB, Infertility
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