Abstract:

Objective To explore the effect of applying GeneXpert MTB/RIF (Xpert for short) test to improve the case finding of pulmonary tuberculosis (PTB) and rifampicin-resistant tuberculosis in economic undeveloped areas. Methods Medical records of PTB patients in Ganzhou Prefecture Jiangxi Province between 2017 and 2020 were derived from the Tuberculosis Management Information System, a subsystem of China Disease Control and Prevention Information System. The effects of intervention measures using Xpert test before (2017-2018) and after (2019-2020) intervention were analyzed. The changes of the proportion of bacteriologically confirmed of tuberculosis, the proportion of rifampicin resistance tested of that, the number of PTB patients with rifampicin resistance, and the number of days for rifampicin resistance test before and after the application of Xpert test were compared and evaluated. Results After the intervention, the proportion of PTB patients received Xpert test increased from 25.89% (3611/13945) to 88.22% (9270/10508) (χ ²=9337.32,P=0.000); the proportion of bacteriologically confirmed PTB cases increased from 44.07% (6146/13945) to 56.12% (5897/10508) (χ²=347.90, P=0.000); the proportion of rifampicin resistance tested of the bacteriologically confirmed cases increased significantly from 52.29% (3214/6146) to 93.18% (5495/5897) (χ ²=2511.49, P=0.000); rifampicin-resistant PTB increased from 207 cases to 305 cases, of which 13.11% (40/305) came from smear-negative patients; the drug susceptibility test was shortened from 63.0 days to the same day. Conclusion The application of Xpert test can significantly improve the case finding of the proportion of bacteriologically confirmed PTB cases and drug-resistant tuberculosis in economic undeveloped areas.

Key words: Tuberculosis,pulmonary, Rifampicin, Drug resistance,bacterial, Nucleic acid amplification techniques, Case finding, Comparative study