The effect of GeneXpert MTB/RIF detection technology in tuberculosis prevention and control program in Xinjiang

doi:10.19982/j.issn.1000-6621.20230321

Abstract

Abstract: Objective: To explore the effect of using GeneXpert MTB/RIF (“GeneXpert” for short) to detect pulmonary tuberculosis and rifampicin resistant pulmonary tuberculosis in the implementation of the “Xinjiang model” of tuberculosis prevention and treatment. Methods: The registration data of pulmonary tuberculosis in Xinjiang Uygur Autonomous Region (“Xinjiang” for short) from 2017 to 2020 were collected from the “Tuberculosis Management Information System”, a subsystem of the “China Disease Prevention and Control Information System”, and the effect of the comprehensive application of GeneXpert detection was analyzed. The etiologically positive rate, rifampicin resistance detection rate, rifampicin resistance cases detected from 2017 to 2020 were evaluated. Results: The coverage rate, detection rate of GeneXpert devices, and overall etiologically positivity rate of all patients increased from 20.00% (22/110), 0.32% (126/39261), and 20.17% (7919/39261) in 2017 to 100.00% (110/110), 75.16% (19610/26090), and 57.94% (15116/26090) in 2020, respectively, and the differences were statistically significant (χ²=40.705, P<0.001; χ²=174.087, P<0.001; χ²=47.569, P<0.001). The number of etiologically positive patients increased from 7919 in 2017 to 15116 in 2020, and the number of GeneXpert positive patients alone increased from 6 in 2017 to 7194 in 2020, accounting for an proportion from 0.08% (6/7919) to 47.59% (7194/15116), with a statistically significant difference (χ²=83.824, P<0.001). The screening rate of rifampicin resistance and the resistance screening rate with GeneXpert in etiologically positive pulmonary tuberculosis patients increased from 44.49% (3523/7919) and 1.85% (65/3523) in 2017 to 99.79% (15084/15116) and 96.13% (14501/15084) in 2020, respectively, and the differences were statistically significant (χ²=133.333, P<0.001; χ²=250.893, P<0.001). Conclusion: The application of GeneXpert detection technology can significantly improve the detection level of etiologically positive and rifampicin resistant pulmonary tuberculosis cases, help the rapid decline of local tuberculosis epidemic in Xinjiang.

Key words: Tuberculosis, pulmonary, Rifampin, Drug resistance, Nucleic acid amplification techniques, Comparative study

CLC Number:

R521

Gulina Badeerhan, Liu Nianqiang, Yipaer Aihaiti, Wang Le, Wang Senlu, Zulikatiayi Abudula, Wang Mingzhe, Zhang Jing, Wang Xinqi, Bi Hongbo. The effect of GeneXpert MTB/RIF detection technology in tuberculosis prevention and control program in Xinjiang[J]. Chinese Journal of Antituberculosis, 2024, 46(2): 173-177. doi: 10.19982/j.issn.1000-6621.20230321

Figures/Tables 4

References 12

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年份	肺结核患者例数	GeneXpert检测		病原学阳性
年份	肺结核患者例数	例数	检测率(%)	例数	阳性率(%)
2017	39261	126	0.32	7919	20.17
2018	72037	4687	6.51	14406	20.00
2019	42288	21780	51.50	19614	46.38
2020	26090	19610	75.16	15116	57.94

年份	涂片阳性	涂阴培阳	仅GeneXpert阳性	合计
2017	7527(95.05)	386(4.87)	6(0.08)	7919(100.00)
2018	11591(80.46)	1642(11.40)	1173(8.14)	14406(100.00)
2019	9977(50.87)	4042(20.61)	5595(28.52)	19614(100.00)
2020	5758(38.09)	2164(14.32)	7194(47.59)	15116(100.00)

年份	病原学阳性例数	耐药筛查例数	耐药筛查率 (%)	检测方法[例(构成比,%)]
年份	病原学阳性例数	耐药筛查例数	耐药筛查率 (%)	传统药物敏感性试验	GeneXpert检测
2017	7919	3523	44.49	3458(98.15)	65(1.85)
2018	14406	8638	59.96	5626(65.13)	3012(34.87)
2019	19614	19559	99.72	1745(8.92)	17814(91.08)
2020	15116	15084	99.79	583(3.87)	14501(96.13)

年份	涂阳肺结核患者		涂阴肺结核患者		合计 (例)
年份	利福平耐药例数	利福平耐药率(%)	利福平耐药例数	利福平耐药率(%)	合计 (例)
2017	231	91.67	21	8.33	252
2018	374	90.12	41	9.88	415
2019	389	63.05	228	36.95	617
2020	196	57.82	143	42.18	339

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