Evaluation of Xpert MTB/ RIF Assay for the Detection of Female Genital Tuberculosis in a Tertiary Care Center- A Descriptive Cross-sectional Study

Aims: Female genital tuberculosis (FGTB) is a silent disease and patients may present with non-specific symptoms irrespective of disease severity and duration. It is a major cause of severe tubal disease leading to infertility. A high degree of suspicion is required for its diagnosis. Conventional diagnostic tests have low sensitivity due to the paucibacillary nature of FGTB. Polymerase chain reaction (PCR) based methods like Xpert MTB/RIF assay hold potential for the early diagnosis of FGTB. The objective of this study was to evaluate the utility of Xpert MTB/RIF assay for the diagnosis of FGTB.

Methodology: Laparoscopy directed endometrial biopsies of 87 samples of females suspected of genital tuberculosis were included in the study. The specimen were subjected to Ziehl Neelson staining, culture on Lowenstein-Jensen media and nucleic acid amplification by Xpert MTB/RIF assay.

Results: Infertility was the most common presenting complaint in 59.77% of cases. None of the samples included in the study was positive by Ziehl – Neelson staining. Culture was positive in 4.6% of the cases. Xpert MTB/RIF assay was positive in 8.05% of cases. Compared with microscopy and culture, Xpert MTB/ RIF assay demonstrated improvement rate in detection of FGTB by 55.55%.

Conclusion: Xpert MTB/RIF assay is a useful tool for the early detection of female genital TB with the advantage of rapid results, minimal hand on time and detection of drug resistance.