Tuberculosis diagnosis in resource-limited settings: Clinical use of GeneXpert in the diagnosis of smear-negative PTB: a case report.
BACKGROUND
The Xpert MTB/RIF test (GeneXpert) has recently been endorsed for use in resource-limited settings for the diagnosis of tuberculosis and drug resistant-tuberculosis. In resource-limited settings, GeneXpert has been used predominantly for research and there is little experience with its use in day-to-day management of patients.


METHODS
We describe a case of a 46 year old HIV-infected male with smear-negative pulmonary tuberculosis, who had several visits to various lower level health centres and two admissions in a tertiary care hospital; however, the diagnosis of tuberculosis was only made several months later on GeneXpert testing that was performed under a research project.


CONCLUSIONS
GeneXpert facilitated identification of tuberculosis in an HIV positive patient in whom the diagnosis had been delayed when more widely available tests were used. Operational and cost-effectiveness studies are needed to provide evidence to policy makers in order to improve access to GeneXpert.
Department of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda ; Research Department, Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala Uganda.
L
L
Nakiyingi
H
H
Nankabirwa
M
M
Lamorde
D057205:Automation, Laboratory; D003955:Diagnostic Tests, Routine / Q000379:methods; D006679:HIV Seropositivity; D006801:Humans; D008297:Male; D008875:Middle Aged; D021141:Nucleic Acid Amplification Techniques / Q000379:methods*; D012680:Sensitivity and Specificity; D013183:Sputum / Q000382:microbiology*; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis*; D014454:Uganda
Tuberculosis; developing countries; molecular diagnostic techniques