Study of GeneXpert MTB/RIF Versus the Routine Methods for Detection of Mycobactrium Tuberculosis

May 7, 2024 updated by: Esraa Hussien Mahran Shehata, Sohag University
  1. Compare the performance of GeneXpert method with the rotine methods including smear microscopy and Lowenstein-Jensen (LJ) media culture to choose the best available test for the diagnosis of TB.
  2. To assess the Gene-Xpert MTB/RIF assay performance in detection of Mycobacterium tuberculosis in smear-negative sputum samples.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

Tuberculosis (TB) infection, caused by Mycobacterium tuberculosis, is a leading cause of mortality worldwide and ranks among the deadliest infectious diseases, including HIV and malaria. Despite global efforts, TB remains a significant public health threat, particularly in developing and underdeveloped countries. The World Health Organization (WHO) has reported that an estimated 10.4 million people contract new TB infections yearly, with 1.8 million TB-related deaths occurring annually.

TB usually affects the lungs, but it can also affect other parts of the body, such as the brain, spine, and many other organ systems. The most common form is pulmonary TB, which is easily spread by aerosol droplets. If another person inhales air containing these droplet nuclei, the probability of getting infected is very high. The chance of transmissibility increases if there is a delay in disease detection and treatment initiation.

Tuberculosis is an infection that requires extensive treatment. Active pulmonary TB patients can transmit the infection through the air then the droplet nuclei move through upper respiratory tract and bronchi to reach the lungs alveoli.

It is critical to treat active pulmonary TB patients as soon as possible in order to decrease the danger of infection spreading to others. The initial stage in TB diagnosis is sputum acid fast bacillus (AFB) staining, which has an advantage of having an average turnaround time (TAT) about 24 hours.

There are a number of tests available for the diagnosis of tuberculosis each having their own limitations. Conventional microscopy has low sensitivity and culture requires longer time for positivity. The commercially available automated, liquid MGIT (Mycobacterium Growth Indicator tube) culture system is time-consuming and requires specialized laboratories. On the other side, nucleic acid amplification techniques not only provide the advantage of rapidity of diagnosis but also detect even low genomic copies in various specimens and curtail the transmission of the disease.

The World Health Organization (WHO) has endorsed the implementation of GeneXpert MTB/RIF assay for national tuberculosis programs in developing countries. The Xpert MTB/RIF (Cepheid Inc.) is an automated, user friendly and rapid test based on nested real-time PCR assay and molecular beacon technology for MTB detection and RIF resistance.

The results are obtained within a short period of time (2 h). Moreover this technique is not prone to cross-contamination, requires minimal Biosafety facilities and has a high sensitivity in smear-negative pulmonary TB. The diagnosis of EPTB is often difficult to establish, considering that number of bacteria in specimens is often very low, a collection often requires invasive procedures, and it is not easy to obtain multiple samples. In this scenario GeneXpert is a potentially useful tool for extrapulmonary specimens.

Study Type

Observational

Enrollment (Estimated)

80

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Sampling Method

Probability Sample

Study Population

  1. Sampling:Morning sputum samples or any suspected fluid as pleural or pus.

  2. Laboratory investigations:

    1. Direct Smear Preparation and Ziehl-Neelsen staining.
    2. MTB culture on Lowenstein-Jensen (LJ) media
    3. Gene-Xpert MTB/RIF assay.

Description

Inclusion Criteria:

All suspected tuberculous patients.

Exclusion Criteria:

  • children
  • Previously disgnosed patients.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
Compare the performance of GeneXpert method with the rotine methods including smear microscopy and Lowenstein-Jensen (LJ) media culture to choose the best available test for the diagnosis of TB.
Time Frame: Baseline
Baseline

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sohag University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

  • AGRAWAL, M., BAJAJ, A., BHATIA, V. & DUTT, S. 2016. Comparative study of GeneXpert with ZN stain and culture in samples of suspected pulmonary tuberculosis. Journal of clinical and diagnostic research: JCDR, 10, DC09. GONG, X., HE, Y., ZHOU, K., HUA, Y. & LI, Y. 2023. Efficacy of Xpert in tuberculosis diagnosis based on various specimens: a systematic review and meta-analysis. Frontiers in Cellular and Infection Microbiology, 13, 500. GUENAOUI, K., HARIR, N., OUARDI, A., ZEGGAI, S., SELLAM, F., BEKRI, F. & TOUIL, S. C. 2016. Use of GeneXpert Mycobacterium tuberculosis/rifampicin for rapid detection of rifampicin resistant Mycobacterium tuberculosis strains of clinically suspected multi-drug resistance tuberculosis cases. Annals of translational medicine, 4. KHAN, A. S., ALI, S., KHAN, M. T., AHMED, S., KHATTAK, Y., IRFAN, M. & SAJJAD, W. 2018. Comparison of GeneXpert MTB/RIF assay and LED-FM microscopy for the diagnosis of extra pulmonary tuberculosis in Khyber Pakhtunkhwa, Pakistan. brazilian journal of microbiology, 49, 909-913. KHATER, E. S. & ABDO, K. H. 2022. Role of Gene-Xpert MTB/RIF assay in detection of Mycobacterium tuberculosis in smear-negative sputum samples. Microbes and Infectious Diseases, 3, 606-614. WILLIAM, T., PARAMESWARAN, U., LEE, W. K., YEO, T. W., ANSTEY, N. M. & RALPH, A. P. 2015. Pulmonary tuberculosis in outpatients in Sabah, Malaysia: advanced disease but low incidence of HIV co-infection. BMC infectious diseases, 15, 1-9. ZUMLA, A., GEORGE, A., SHARMA, V., HERBERT, R. H. N., OXLEY, A. & OLIVER, M. 2015. The WHO 2014 global tuberculosis report-further to go. The Lancet Global Health, 3, e10-e12.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

June 1, 2024

Primary Completion (Estimated)

June 1, 2026

Study Completion (Estimated)

July 1, 2026

Study Registration Dates

First Submitted

May 7, 2024

First Submitted That Met QC Criteria

May 7, 2024

First Posted (Estimated)

May 10, 2024

Study Record Updates

Last Update Posted (Estimated)

May 10, 2024

Last Update Submitted That Met QC Criteria

May 7, 2024

Last Verified

May 1, 2024

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • Soh-Med-24-4-08MD

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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