Evaluation of Xpert® MTB/RIF assay as a diagnostic test for pulmonary tuberculosis in children in Myanmar

BACKGROUND: The Xpert (R) MTB/RIF assay has been recommended for the diagnosis of pulmonary tuberculosis (PTB). However, there are limited data from the South-East Asian region. SETTING: This study was carried out at a tertiary-level children's hospital in Mandalay, Myanmar. OBJECTIVE : To evaluate the performance of Xpert as a diagnostic test for PTB in children. METHODS : A cross-sectional descriptive study of children with suspected PTB. Gastric lavage aspirate samples were tested using Xpert, solid culture and smear microscopy. The performance of Xpert, solid culture and smear microscopy were evaluated using the revised National Institute of Health classification for intrathoracic TB in children as the reference standard. RESULTS : TB was bacteriologically confirmed in 38 (16.5%) of 231 children with suspected PTB. Of the 38 children with confirmed TB, 36 cases were identified using Xpert, 16 using solid culture and 12 using smear microscopy. With confirmed TB as the reference standard, the sensitivity of Xpert, solid culture and smear microscopy was respectively 94.7% (95% CI 80.9-99.1), 42.1% (95% CI 26.7-59.1) and 31.6% (95% CI 18.0-48.8). CONCLUSION: Xpert has improved the bacteriological confirmation of PTB among hospitalised children in Myanmar.