Introduction: Tuberculosis (TB) is a major cause of morbidity and mortality worldwide. It represents a major public health problem. The objective of this study is to evaluate the role of the Xpert test in the microbiological diagnosis of TB in children in the Haut-Uélé province, eastern Democratic Republic of the Congo (DRC). Methods: Analytical cross-sectional study was conducted from January 1, 2019 to December 31, 2023 in the Haut-Uélé province in eastern DRC. A total of 105 children aged 0 to 15 years clinically diagnosed as TB cases were included in this study. Clinical, paraclinical and therapeutic data were collected in the following health care facilities (HCFs): Isiro General Reference Hospital (HGR), Watsa HGR and Kibali Hospital Center (CHK). These data were entered into Excel software and processed with R software version 4.4.2. Results: In multivariate analysis, weight (OR = 0.85; [95% CI = 0.72 - 0.98]) and being on anti-tuberculosis treatment (OR = 19.7; [95% CI = 2.25 - 442]) were significantly associated with a positive GeneXpert result. Weight loss (OR = 6.26; [95% CI = 0.93 - 150]), dyspnea (OR = 2.36; [95% CI = 0.80 - 7.15]) and neurological disorders (OR = 12.6; [95% CI = 0.74 - 576]) multiplied the risk of GeneXpert positivity in a non-significant manner. Conclusion: The GeneXpert test has proven its value in contributing to the diagnosis of tuberculosis in children in our setting. It was positive in most patients with a clinical picture characteristic of tuberculosis in both bivariate and multivariate analysis.
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