Diagnostic Performance of GeneXpert for Pulmonary Tuberculosis among Presumptive Cases in Resource-Constrained Settings of Bangladesh
Keywords:
Pulmonary Tuberculosis, diagnostic performance, GeneXpert, sputum microscopyAbstract
Background: Tuberculosis (TB) is an emerging global health burden in low- and middle-income countries (LMICs), where diagnosis often relies on sputum microscopy is a method with low sensitivity that misses numerous cases.
Objective: This study directed to assess the diagnostic performance of GeneXpert in detecting pulmonary TB among presumptive cases and compare it with conventional sputum microscopy.
Methodology: This cross-sectional study assessed 887 presumptive TB patients from two resource constrained Upazila, Bhaluka and Kishoreganj, Bangladesh, between January and June 2020. TB diagnosis was performed using both GeneXpert and sputum microscopy, with results compared across age groups, genders, and sputum types at primary local diagnostic centers.
Results: The study population was predominantly male (67.4%), with most patients aged ≥45 years. GeneXpert identified 132 TB cases (14.9%), detecting 32 more cases than sputum microscopy (11.3%). Across all age groups and both genders, GeneXpert showed higher sensitivity, particularly in the 15 to 29 and 45 to 59 year groups. Regarding sputum types, the highest TB positivity was found in purulent specimens, with GeneXpert again demonstrating superior performance, especially in mucopurulent samples.
Conclusion: GeneXpert significantly outperformed sputum microscopy in detecting pulmonary TB across all demographic and clinical subgroups. Its higher sensitivity, particularly in younger and middle-aged adults and varied sputum types, supports its broader implementation as the initial diagnostic tool in resource-constrained settings.
Bangladesh Journal of Infectious Diseases, June 2026;13(1):43-50
86
100
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Mohammad Nurunnabi, Tonmoy Kumar Dutta, Kazi Mariam Nahar, K. M. Hafizur Rahman, Md. Didarul Islam, Tarana Jahan
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Copyright
Copyright on any research article in the Bangladesh Journal of Infectious Diseases is retained by the author(s).
The authors grant the Bangladesh Infection Research Association a license to publish the article and identify itself as the original publisher.
Articles in the Bangladesh Journal of Infectious Diseases are Open Access articles published under the Creative Commons CC BY-NC License (https://creativecommons.org/licenses/by-nc/4.0/)
This license permits use, distribution and reproduction in any medium, provided the original work is properly cited, and it is not used for commercial purposes.
