Evaluation of Novel Chip Based Test - Truenat with Traditional Genexpert for Detection of Tubercular Meningitis
Anurag Agarwal
Department of Pediatrics Maulana Azad Medical College and Lok Nayak Hospital, New Delhi -110002, India.
Stuti Sharma
*
Department of Pediatrics Maulana Azad Medical College and Lok Nayak Hospital, New Delhi -110002, India.
Ashwani Khanna
Lok Nayak Hospital. New Delhi -110002, India.
Raghvendra Singh
Department of Pediatrics Maulana Azad Medical College and Lok Nayak Hospital, New Delhi -110002, India.
Reema Arora
Lok Nayak Hospital. New Delhi -110002, India.
*Author to whom correspondence should be addressed.
Abstract
Background: TRUENAT is a novel chip based test developed in India. Its use for pulmonary samples has been approved by World Health Organisation. Government of India has recently approved it for Extrapulmonary cases.
Aim: To study the role of TRUENAT in diagnosis of Tubercular Meningitis(TBM) and the co-relation between TRUENAT and GeneXpert.
Study Design: Prospective study.
Subjects and Methods: 75 Children and adolescents with strongly suggestive TBM as per NTEP guidelines [1] were enrolled. Clinical, Radiological and Cerebrospinal fluid(CSF) analysis were carried out. CSF was tested by TRUENAT and GeneXpert.
Results: TRUENAT detected 13/75 cases in comparison to GeneXpert which detected 16/75 cases. Out of these, in only 4 samples MTB was detected by both these tests. Concordance between the two tests was 72%. Cohen kappa (k-0.105) analysis showed slight agreement between the two tests. Higher CSF count(>10cell) was associated with higher chances of positivity in GeneXpert as well as TRUENAT.
Conclusion: TBM diagnosis requires a combination of clinical, radiological and biochemical parameters. Molecular tests alone cannot detect bacilli in many cases. A single molecular test which targets additional genes could provide higher detection.
Keywords: Cerebrospinal fluid, genexpert, pediatrics, truenat, tubercular meningitis