Mulualem Tadesse Jano Poster 2025

Dr Mulualem Tadesse Jano

Jimma University, Ethiopia

High Rate of Indeterminate Rifampicin-Resistance in Pulmonary Tuberculosis Patients at Shenen Gibe Hospital, Jimma, Ethiopia: Implications for programmatic use of Xpert MTB/RIF Ultra Assay

Poster Abstract

Background: The Xpert MTB/RIF Ultra assay, a rapid molecular technique, is recommended by the World Health Organization recommended for the rapid identification of Mycobacterium tuberculosis and detection of rifampicin-resistance. However, there is limited data on the programmatic implementation of the Xpert MTB/RIF Ultra assay for detecting rifampicin-resistant Mycobacterium tuberculosis in Ethiopia.

Methods: A retrospective cross-sectional study was conducted at Shenen Gibe General Hospital. A checklist was used to gather demographic and clinical data and results from Xpert MB/RIF Ultra test and rifampicin-resistance as well as cycle threshold (Ct) values, from patients’ records and the Xpert Ultra desktop computer. Semiquantitative mycobacterial load results were categorized as very low (Ct>29), low (Ct 25–28), medium (Ct 19–24), or high (Ct 15–18.9). The data were entered and analyzed by using SPSS v.26 software.

Results: A total of 192 Xpert MTB/RIF Ultra-positive TB patients were included in the study. Out of these, 31.3% (60/192) had a high grade, 22.9% (44/192) had a low grade, 13.5% (26/192) had a medium grade, 18.2% (35/192) had a very low grade, and 14.1% (27/192) had a trace call. Rifampicin-resistance was detected in 4.2% (8/192) pulmonary TB patients. Unexpectedly, 14.6% (28/192) of Xpert MTB/RIF Ultra-positive sputum samples were found to be indeterminate for rifampicin-resistance. Notably, all trace results were found to be indeterminate for rifampicin-resistance by Xpert MTB/RIF Ultra.

Conclusion: A high proportion of Xpert MTB/RIF Ultra-positive sputum samples were found to be indeterminate for rifampicin-resistance, which could lead to delays or incorrect treatment decisions, potentially affecting treatment outcomes and disease transmission. Further research is urgently needed to understand the implication of Xpert MTB/RIF Ultra trace results in patient management within the routine standard of care.

Biography

Dr. Mulualem Tadesse Jano is a postdoctoral researcher and associate professor at Jimma University, specializing in infectious disease research, particularly tuberculosis, in Ethiopia. He holds a PhD in Biomedical Science from the University of Antwerp and completed a WHO/TDR Fellowship at FIND in Geneva. His research primarily focuses on evaluation of innovative tuberculosis diagnostic techniques in TB patients who are difficult to diagnose. Dr. Mulualem actively teaches and mentors postgraduate and undergraduate students, guiding them in project development, study design, and writing. He has supervised numerous MSc and PhD students, led various research projects, and published over 30 articles.