Abstract:
The application of Gene Xpert MTB/RIF® assay for testing non-sputum clinical samples in Western Kenya
has not been reported. We are reporting on use of Zn, CD4 count, Hb, Creatinine, Proteinuria, and
Hematuria as optimal parameters for Gene Xpert MTB/RIF and LAM Strip determine Test for diagnosis of
tuberculosis. Urine from HIV/TB co-infected adults (n=158) with CD4+ count <200 cells/mm3was analyzed
for mycobacteria tuberculosis DNA. Acid fast-staining, culture, clinical symptoms, laboratory and
radiological findings were also assessed. Acid fast staining(55%) were TB positive, however, Gene Xpert test
revealed 17(11%) of the patients were TB positive with 94% and 6% being MTB detected low and medium,
respectively. Rifampicin resistance was not detected in 88% of the TB Gene Xpert positive patients with the
remaining (12%) being indeterminate. LAM test revealed that 28% of the patients were TB positive.
Radiology revealed that 45% of the patients had infiltrates. Presence of protein or blood in urine was
significantly associated with TB positivity based on LAM strip determine test (48% vs 24%; p-value=0.021).
The weighted kappa coefficient was 0.48 (95% CI 0.32-0.63; exact p-value <0.0001).The findings of this
study show that urine Xpert MTB/RIF® can be used for diagnosis of TB using urine and taking Zn, CD4
count, Proteinuria, and Hematuria as optimal parameters.