A meta-analysis of GeneXpert MTB/RIF in the diagnosis of tuberculosis in Chinese suspected tuberculosis population

Yuwei Li¹, Xia Li^1,2*, Hengli Liu², Yanyun Zhang²

¹School of Public Health, Dali University, Dali 671000,Yunnan, China - ²Department of Infectious Diseases, Yunnan Provincial Hospital of Infectious Disease/Yunnan AIDS Care Center, Kunming 650301, Yunnan, China

Introduction: To determine the value of GeneXpert MTB/RIF in the diagnosis of tuberculosis (TB) in Chinese patients with suspected TB.

Materials and methods: The Cochrane Library, Embase, Pubmed, China National Knowledge Internet (CNKI), VIP database, and Wanfang database were explored to search the studies on the diagnosis of suspected tuberculosis in the Chinese population using GeneXpert MTB/RIF method. The search time was limited to October 2021. Literature screening and data retrieval were conducted by two investigators independently. Quality Assessment Of Diagnostic Accuracy Studies (QUADAS-2) was applied to evaluate the quality of the included studies. Meta-analysis was performed using Review Manager 5.4, Stata13, and Meta-Disc5.4 software. Subgroup analysis was performed according to the gold standard type and region. The random-effects model was to diagnostic accuracy indicators.

Results: Nineteen studies (10,773 sputum samples) were included in the meta-analysis, with a pooled sensitivity of 88% (95% CI: 87% to 89%), a pooled specificity of 92% (95% CI: 92% to 93%), I2 = 93.4%, AUC = 0.9591, and a Q-index of 0.9. There was no statistical difference between different gold standards (solid culture versus liquid culture). Moreover, there was no statistical difference before in different regions.

Conclusions: GeneXpertMTB/RIF is rapid and effective for TB screening in patients with suspected TB using sputum specimens, with no regional differences in the Chinese population.