Comparison of the Diagnostic Effectiveness of Tuberculosis Microscopy and GeneXpert MTB/RIF with Mycobacterium tuberculosis Cultures from Patients with Suspected Tuberculosis in Chaiyaphum Hospital. ; เปรียบเทียบประสิทธิผลการวินิจฉัยวัณโรคด้วยกล้องจุลทรรศน์และ GeneXpert MTB/RIF กับการเพาะเลี้ยงเชื้อวัณโรคในตัวอย่างเสมหะจากผู้ป่วยที่สงสัยน่าจะเป็นวัณโรคในโรงพยาบาลชัยภูมิ

Background: There are several methods for laboratory diagnosis of tuberculosis e.g., AFB microscopy, TB culture, GeneXpert MTB/RIF assay. GeneXpert MTB/RIF assay was recommended by WHO for TB and Rifampicin-resistant TB diagnosis. Objective: To compare diagnostic effectiveness of AFB microscopy and GeneXpert MTB/RIF with Mycobacterium tuberculosis cultures from patients with suspected tuberculosis in Chaiyaphum Hospital. Study design: A Cross sectional study, 120 sputum-samples were investigated by all tests (AFB Microscopy, GeneXpert MTB/RIF and TB culture). Cochran’s Q test, Post Hoc test and McNemar Chi-Square test were used for statistical analysis. Results: Percentage of Sensitivity, Specificity, PPV and NPV were found as follows: 1) GeneXpert MTB/RIF compared with TB culture were 88, 87, 62 and 9, respectively 2) AFB Microscopy compared with TB culture were 33, 100, 100 and 86, respectively 3. AFB Microscopy compared with GeneXpert were 24, 100, 100 and 77, respectively. Diagnostic effectiveness comparison of with GeneXpert MTB/RIF, AFB Microscopy or TB Culture alone by Cochran’s Q test found at least one paired had statistically significant (P-valve < 0.001 there were two pairs of shown the differences; a comparison between AFB Microscopy with TB culture had p-Value = 0.001 and a comparison between GeneXpert MTB/RIF with AFB Microscopy had p-Value <0.001. Whereas a comparison between GeneXpert MTB/RIF with TB culture had P-Value =0.69. Conclusion: TB culture is superior than AFB Microscopy, GeneXpert MTB/RIF is superior than AFB Microscopy. Whereas, Diagnostic effectiveness of GeneXpert MTB/RIF with TB culture has no statistically significant. Therefore, for clinical practice, we recommend GeneXpert MTB/RIF without AFB Microscopy because GeneXpert MTB/RIF is faster for TB diagnosis and patients isolation in population or risk group that had abnormal chest X-ray results. ; ความสำคัญของปัญหา การตรวจวินิจฉัยหาเชื้อวัณโรคทางห้องปฏิบัติการ มีหลายวิธี ได้แก่ การตรวจหาเชื้อวัณโรคด้วยกล้องจุลทรรศน์ (AFB ...