Özet:

Indonesia is the 2nd country with the highest tuberculosis (TB) caseload in the world. Inappropriate TB treatment may lead to multidrug-resistance tuberculosis (MDR-TB) development. TB rapid detection is important, and very much needed, to prevent transmission and deaths due to this disease. The Xpert® MTB/RIF is proposed to address this problem. This study aimed to assess the performance of the Xpert® MTB/RIF test in West Java, Indonesia. This was a cross-sectional study conducted on MDR-TB suspects referred to Dr. Hasan Sadikin General Hospital Bandung, West Java, Indonesia, using data from the eTB Manager. The performance of Xpert® MTB/RIF testing and its validity was tested against conventional drug susceptibility testing (DST). In total, data from 4,452 MDR-TB suspects were retrieved but only 578 data that had both DST and Xpert® MTB/RIF results were included in the study. The Xpert® MTB/RIF showed a sensitivity of 88% (95%CI: 85%-91%), specificity of 66% (95%CI: 60%-72%), positive predictive value of 79% (95%CI: 75%-83%), and negative predictive value of 80% (95%CI: 74%-85%), with a detection accuracy of 79%. Xpert® MTB/RIF test in this study shows a good performance for the diagnosis of MDR-TB when compared to the Mycobacterium tuberculosis culture as the gold standard. Therefore, rapid Xpert® MTB/RIF examination is recommended for MDR-TB screening for countries with a high TB burden as a complementary tool to the reference standard test.

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