Indonesia is one of the few countries in the world with very high burden of tuberculosis (TB). Tubercular pleural effusion (Pleural TB) is the most common form of extra-pulmonary TB, however the remains a common clinical challenge. This research from May 2017 through September 2017 a total of 42 patients with exudative lymphocytic pleural effusions suspected to pleural tuberculosis were enrolled in this study. Adenosine deaminase (ADA) and Gene X-pert were examined from pleural fluid. Diagnosis was made clinically or based from sputum/pleural fluid culture. The result of this research showed out of all participants, 64,3% (27/42) had ADA in positive level (>40 IU/L) and 31% (13/24) had Gene X-pert positive Mycobacterium Tb. The Gene X-pert sensitivity was 40.7% with specificity 86.6%, PPV and NPV were 44.8% and 57.1% respectively. Kappa Compatibility study show that Gene X-pert point was 0.227 (p 0.066). The usefulness of Gene X-pert to diagnose pleural TB is limited by its poor sensitivity. Gene X-pert cannot be used as single diagnostic tool for tuberculous pleural effusion
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