GeneXpert has perfect test agreement with WHO recommended TB lipoarabinomannan antigen test for the diagnosis of TB among under five children from urine sample in Tuberculosis endemic setting of Ethiopia

Abstract

Abstract Background Tuberculosis (TB) is one of the leading public health problems in children mainly due to difficulties in the diagnosis of disease in children. This study aimed to detect the diagnostic agreement between GeneXpert MTB/RIF and WHO recommended lipoarabinomannan (LAM) antigen test for the detection of TB in children using urine samples Methods Institutional based cross-sectional study was conducted on 337 children in Wolaita Sodo University comprehensive hospital. LAM antigen and GeneXpert methods were used to detect TB from urine sample. The agreement between two tests was assessed using Kappa statistics with the standard error (SE), concordance and disagreements statistics. Logistic regression was used to determine factors associated with TB and P-values less than 0.05 were considered as having a statistically significant association. Results M. tuberculosis was detected in 26 using TB LAM giving an overall prevalence of 7.7% and 29 (8.6%) using GeneXpert. The two tests had almost perfect agreement (Concordance of 99.1% and kappa value of 0.94 with standard error of 0.034) for the detection of TB in urine sample. Co-infections with other diseases [AOR = 4.00: 95% CI, 1.428, 11.203], cough for the previous two weeks [AOR = 3.700: 95% CI, 1.039, 13.183], night sweat [AOR = 4.255: 95% CI, 1.453, 12.463] and loss of appetite [AOR = 3.994: 95% CI, 1.444, 11.045] had significant associations with pulmonary TB among children in the study area. Conclusion Tuberculosis was still the public health concern among children of under five years old in the study area. The GeneXpert had almost perfect test agreement with WHO recommended TB LAM antigen test for the diagnosis TB among under five children, however, it needs further confirmation study with large sample size to use as diagnostic test.