Diagnostic performance of GeneXpert and Ziehl-Neelson microscopy in the detection of tuberculosis in Benue State, Nigeria

Abstract Background Accurate and timely diagnosis of tuberculosis (TB) is key to effective treatment and management. This study was designed to compare the diagnostic performance of GeneXpert and Ziehl-Neelson (ZN) microscopy test using culture as the reference. Methods Cross-sectional study was conducted in a tertiary hospital to compare the performance of GeneXpert and ZN test among HIV and non-HIV patients. Sputum samples were collected from 261 suspected TB patients and analyzed in the laboratory using GeneXpert, ZN test and culture. Statistical analysis included calculation of sensitivity, specificity, positive predictive value and negative predictive value. χ 2 was used to compare the outcome of diagnostic test and demographic variables. p-value  Results Comparison of TB prevalence among urban versus rural areas using the three diagnostic tests are: ZN test: 32 (12.3%) vs 16 (6.1%; χ 2 7.63, P = 0.007); GeneXpert: 63 (16.1%) vs 20 (7.7%, χ 2 9.01, P = 0.003) and culture: 22 (8.4%) vs 10 (3.8% χ 2 4.44, P = 0.05). Also, prevalence of TB was significantly (P  Conclusion GeneXpert demonstrated higher level of performance than ZN microscopy. We recommend the use of GeneXpert for diagnosis of TB in Benue State and Nigeria in general for effective treatment and management of tuberculosis.