Diagnostic Performance of Gene Xpert MTB/RIF in Cerebrospinal Fluid for Tuberculous Meningitis in Children
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background: Tuberculous meningitis in children is a severe disease with substantial mortality and disability, and diagnosis is challenging due to nonspecific clinical features and low bacillary load. Gene Xpert MTB/RIF has limited sensitivity, highlighting the need for more sensitive diagnostic methods such as Xpert Ultra. Objective: To assess the diagnostic performance of Gene Xpert MTB/RIF in cerebrospinal fluid for the diagnosis of tuberculous meningitis in children. Materials and Methods: This prospective, cross-sectional study was conducted at the Department of Paediatrics, Dhaka Medical College Hospital (DMCH), Dhaka, Bangladesh, from July 2020 to June 2021, involving 80 children aged 1 month to <12 years with suspected tuberculous meningitis. CSF was tested by AFB staining, Gene Xpert MTB/RIF, Gene Xpert MTB/RIF Ultra, and mycobacterial culture. Diagnostic performance was assessed using culture as the reference standard, and data were analyzed using SPSS version 26.0. Results: Among 80 children, 54 (67.5%) were aged <5 years and 48 (60.0%) were male, with fever in all cases. CSF culture was positive in 10 (12.5%). Sensitivity was 60.0% for AFB staining, 40.0% for Gene Xpert, and 100.0% for Xpert Ultra, with specificities of 97.14%, 85.71%, and 77.14%, respectively. Accuracy was 92.5%, 80.0%, and 80.0%, respectively. Rifampicin resistance was detected in 2 (7.7%) Xpert Ultra-positive cases. Conclusion: Gene Xpert MTB/RIF is a highly specific and valuable rapid diagnostic tool for the early detection of tuberculous meningitis in children and can complement conventional microbiological methods and CSF culture.
Source: Barind Medical College Journal
Authors: Arifur Rahman, Sayeeda Anwar, Naznin Akter, Shamim Ferdous Khan, Khadija Rahman, Hasan Moshiur Shawon, Mainul Huq, Ferdous Sharmin
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W7204643270