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Background: Childhood TB constitutes 10-20% of all TB cases in high burden countries like India and accounting for 8-20% of TB related deaths. Diagnosis of TB in children is difficult. One test, CBNAAT which was recently endorsed by WHO has the potential to lead a revolution in diagnosis of active TB disease.Methods: A cross sectional study in SCB MCH and SVPPGIP, Cuttack in all the suspected TB patients admitted during the period from January 2016 to October 2017.Results: A total of 100 suspicious patients admitted to the Department of Pediatrics in SCB MCH and SVPPGIP during the study period. Of these 45 were diagnosed TB and rest others were diagnosed otherwise than TB. Diagnosis of TB was established on basis of Microscopy, CBNAAT, culture, biochemistry, cytology, clinical findings, neuroimaging, FNAC/biopsy, USG abdomen. Out of 45 TB patients 30 were CBNAAT positive taking the body fluid samples other than blood, urine and stool with a sensitivity of 66.7% and specificity of 100%. Out of 45 TB patients 14 were having ZN Smear positive taking the same fluid sample with a sensitivity of 31.1% and specificity of 100%. Whereas out of these 45 TB patients 32 were MGIT culture positive taking the same sample with a sensitivity of 71.1% and specificity of 100%. When diagnostic performances of CBNAAT and MGIT culture were compared, it was found to be statistically insignificant with a P value 0.54.Conclusions: The CBNAAT is able to confirm a diagnosis of TB with 66.7% sensitivity and 100% specificity within 2 hours. We can use CBNAAT as a diagnostic method as it provides rapid result and simultaneous better sensitive result, it can be helpful in starting ATT in sick patients and also in outdoor patients.
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Objective: To characterize mycobacterium isolates from pulmomary tuberculosis suspected cases visiting National Tuberculosis Reference Laboratory at Ethiopian Health and Nutrition Research Institute, for diagnosis of pulmonary tuberculosis from January 4 to February 22, 2010 with total samples of 263. Methods: Sputum specimens were collected and processed; the deposits were cultured. For culturing Lowenstein Jensen medium (LJ) and Mycobacteria Growth Indicator Tube (BACTEC MGIT 960) were used. Capilia Neo was used for detecting NTM isolates from isolates of BACTEC MGIT 960. In Armauer Hansen Research Institute, Addis Ababa Ethiopia, Deletion typing PCR method for species identification (from confirmed Mycobacterium tuberculosis complex (MTBC) isolates by Capilia Neo) was done. Results: Out of 263 enrolled in the study, 124 and 117 of them were positive for mycobacterium growth by BACTEC MGIT 960 and LJ culture method, respectively. From BACTEC MGIT 960 positive media of 124 isolates, 117 were randomly taken to perform Capilia TB Neo test. From these 7 (6%) of them were found to be NTM and 110 (94%) were MTBC. From these 110 MTBC isolates, 81 of them were randomly taken and run by the deletion typing RD9 PCR method of molecular technique. Out of these 78 (96.3%) were found to be species of Mycobacterium tuberculosis and 3 (3.7%) were found to be not in the MTBC. Regarding the types of methods of culture media, Mycobacteria Growth Indicator Tube (BACTEC MGIT 960) method was found to have excellent agreement (with kappa value of 0.78) with the routine method of LJ. Conclusions: Pulmonary tuberculosis suspected cases visiting the National Tuberculosis Reference Laboratory at EHNRI that were confirmed to be pulmonary tuberculosis are caused by the species of Mycobacterium tuberculosis, hence treatment regimen including pyrazinamide can be applied to the patients as the first choice in the study area in Addis Ababa, Ethiopia. There is indication of the presence of NTM in patients visiting the tuberculosis reference laboratory and this is important because NTM is known to cause pulmonary disease similar with sign and symptom of pulmonary tuberculosis but different in treatment. BACTEC MGIT 960 has excellent agreement with LJ media but it has high tendency of having high contamination rate unless a better decontamination method is designed.
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OBJECTIVE@#To characterize mycobacterium isolates from pulmomary tuberculosis suspected cases visiting National Tuberculosis Reference Laboratory at Ethiopian Health and Nutrition Research Institute, for diagnosis of pulmonary tuberculosis from January 4 to February 22, 2010 with total samples of 263.@*METHODS@#Sputum specimens were collected and processed; the deposits were cultured. For culturing Lowenstein Jensen medium (LJ) and Mycobacteria Growth Indicator Tube (BACTEC MGIT 960) were used. Capilia Neo was used for detecting NTM isolates from isolates of BACTEC MGIT 960. In Armauer Hansen Research Institute, Addis Ababa Ethiopia, Deletion typing PCR method for species identification (from confirmed Mycobacterium tuberculosis complex (MTBC) isolates by Capilia Neo) was done.@*RESULTS@#Out of 263 enrolled in the study, 124 and 117 of them were positive for mycobacterium growth by BACTEC MGIT 960 and LJ culture method, respectively. From BACTEC MGIT 960 positive media of 124 isolates, 117 were randomly taken to perform Capilia TB Neo test. From these 7 (6%) of them were found to be NTM and 110 (94%) were MTBC. From these 110 MTBC isolates, 81 of them were randomly taken and run by the deletion typing RD9 PCR method of molecular technique. Out of these 78 (96.3%) were found to be species of Mycobacterium tuberculosis and 3 (3.7%) were found to be not in the MTBC. Regarding the types of methods of culture media, Mycobacteria Growth Indicator Tube (BACTEC MGIT 960) method was found to have excellent agreement (with kappa value of 0.78) with the routine method of LJ.@*CONCLUSIONS@#Pulmonary tuberculosis suspected cases visiting the National Tuberculosis Reference Laboratory at EHNRI that were confirmed to be pulmonary tuberculosis are caused by the species of Mycobacterium tuberculosis, hence treatment regimen including pyrazinamide can be applied to the patients as the first choice in the study area in Addis Ababa, Ethiopia. There is indication of the presence of NTM in patients visiting the tuberculosis reference laboratory and this is important because NTM is known to cause pulmonary disease similar with sign and symptom of pulmonary tuberculosis but different in treatment. BACTEC MGIT 960 has excellent agreement with LJ media but it has high tendency of having high contamination rate unless a better decontamination method is designed.
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Objective:To characterize mycobacterium isolates from pulmomary tuberculosis suspected cases visitingNationalTuberculosisReferenceLaboratory atEthiopianHealth andNutritionResearch Institute, for diagnosis of pulmonary tuberculosis fromJanuary4 toFebruary22,2010 with total samples of263.Methods:Sputum specimens were collected and processed; the deposits were cultured.For culturingLowensteinJensen medium(LJ) andMycobacteriaGrowthIndicatorTube (BACTECMGIT960) were used.CapiliaNeo was used for detectingNTM isolates from isolates of BACTECMGIT960.InArmauerHansenResearchInstitute,AddisAbabaEthiopia,Deletion typing PCR method for species identification(from confirmedMycobacterium tuberculosis complex (MTBC) isolates byCapiliaNeo) was done.Results:Out of263 enrolled in the study,124 and117 of them were positive for mycobacterium growth byBACTECMGIT960 andLJ culture method, respectively.FromBACTECMGIT960 positive media of124 isolates,117 were randomly taken to performCapiliaTBNeo test.From these7(6%) of them were found to beNTM and110(94%) were MTBC.From these110MTBC isolates,81 of them were randomly taken and run by the deletion typingRD9PCR method of molecular technique.Out of these78(96.3%) were found to be species ofMycobacterium tuberculosis and3(3.7%) were found to be not in theMTBC.Regarding the types of methods of culture media,MycobacteriaGrowthIndicatorTube(BACTECMGIT960) method was found to have excellent agreement(with kappa value of0.78) with the routine method of LJ.Conclusions:Pulmonary tuberculosis suspected cases visiting theNationalTuberculosis ReferenceLaboratory atEHNRI that were confirmed to be pulmonary tuberculosis are caused by the species ofMycobacterium tuberculosis, hence treatment regimen including pyrazinamide can be applied to the patients as the first choice in the study area inAddisAbaba,Ethiopia.There is indication of the presence ofNTM in patients visiting the tuberculosis reference laboratory and this is important becauseNTM is known to cause pulmonary disease similar with sign and symptom of pulmonary tuberculosis but different in treatment.BACTECMGIT960 has excellent agreement withLJ media but it has high tendency of having high contamination rate unless a better decontamination method is designed.
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Introduction: Extra pulmonary form of tuberculosis is an important public health disease which cannot be ignored because of its low transmissibility. Data on the exact burden of the disease in developing countries is scarce. Aim: To assess the burden of the disease in a tertiary care hospital of India. To study the clinical trends in the disease, and the utility of various diagnostic modalities for its diagnosis. To identify the Mycobacterial species and perform drug susceptibility test. Materials and Methods: A cross sectional study was carried out for a period of two years. A total of one hundred and forty seven samples were tested for extrapulmonary tuberculosis using a combination of bacteriological, cytological, histological and biochemical techniques to achieve proper diagnosis of the disease. Results: Young adults and females predominated in the study group and positive cases. Microbiologically, 26% of the specimens were positive. Eighteen percent of them were found to be culture positive for M. tuberculosis. Smear by Ziehl Neelsen stain was positive in 9%. A combination of culture media both solid and liquid maximized the yield of Mycobacteria. Lymph node tuberculosis was found to be the predominant type followed by others. Fifteen percent of the strains were found to be resistant to the first line drugs used in treatment of tuberculosis. Cytology and biochemical findings were found to be less specific in diagnosis of extrapulmonary tuberculosis. Conclusion: Extrapulmonary form of tuberculosis is seen in significant number of the suspects. Hence, attention should be paid towards its proper and early diagnosis followed by rational management, as if neglected may lead to associated complications and sequalae.
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Introduction: The revised national tuberculosis control program of India has been able to reduce the disease burden significantly. Despite; TB continues to affect 40% of our population. To achieve the desired goal of NSP {national strategic plan} 2012-2017 we need to have a focused approach on the disease prevalence and the most vulnerable. Aim: To estimate the burden of tuberculosis both pulmonary and extra pulmonary in non HIV patients at a tertiary care hospital in Hyderabad Telangana state South India. Materials and Methods: Over a period of two years from Jan.2013- Jan.2015 a total of two hundred and twenty six specimens, seventy eight from pulmonary and one hundred forty eight from extra pulmonary tuberculosis suspects were processed by various methods to achieve diagnosis. Results: Microbiologically the disease was observed in 25% of the studied subjects. Pulmonary tuberculosis accounted for 10% and extra pulmonary in 15%. Overall smear by ZN stain was positive in 17% and culture in 20%. Cytology could detect disease in 67% of the suspects. Biochemical findings were insignificant. Drug resistance was noted in 4.4% of the cases. Drug resistance and MDR tuberculosis was more common in pulmonary form than in extra pulmonary. Females dominated both in the suspect’s and culture confirmed cases as 53% & 76% respectively. The most affected age group for extra pulmonary disease remained as 6-35 years for both the sexes. In case of pulmonary tuberculosis it was noted as 36-50 years for men. Conclusion: TB affects one third of the suspects. In the present study EPTB has exceeded PTB in the proportion of the laboratory confirmed suspects of tuberculosis. Both the forms of disease are more common in females and young age which needs to be prioritized in the control program to achieve the desired target of NSP.
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Background and Objectives: Antimycobacterial susceptibility tests take weeks, and delayed therapy can lead to spread of Mycobacterium tuberculosis. Therefore, rapid, accurate and cost-effective methods are required for proper therapy selection. In this study, the Mycobacteria growth indicator tube (MGIT) and epsilometer test (Etest) methods were compared to the agar proportion method for susceptibility testing of Mycobacterium tuberculosis. Materials and Methods: The susceptibility tests against isoniazid (INH), rifampin (RIF), streptomycin (STM) and ethambutol (ETM) of 51 M. tuberculosis complex isolates were analyzed by the MGIT, Etest and agar proportion methods. Results: The concordance between MGIT/Etest and agar proportion methods was 98% for INH and 100% for RIF, STM, ETM. There were not statistically significant differences in results of the susceptibility tests between MGIT/Etest and the reference agar proportion method. Conclusion: The results have shown that MGIT and Etest methods can be used instead of the agar proportion method, because these two methods are more rapid and easier than the agar proportion method.