RESUMO
Background: The aim of study is to evaluate the diagnostic value of the CBNAAT in BAL samples of smear negative for AFB or who could not produce an expectorated sputum sample.Methods: A prospective and observational study of in patient and out patient department in Department of Pulmonary Medicine of Chalmeda Anand Rao Institute of Medical Sciences, Karimnagar during the period November 2017 to November 2018.Results: Bronchoalveolar lavage cartridge based nucleic acid amplification test in bronchoalveolar lavage was done for 60 samples of patients who were having history and chest x-ray suggestive of pulmonary tuberculosis with sputum AFB negative. Out of these sputum negative samples 25 were BAL CBNAAT positive and rest were negative.Conclusions: CBNAAT adds significantly to the diagnostic yield of PTB in comparison to sputum smear microscopy. It has additional advantage of identifying rifampicin resistance with high sensitivity and specificity.
RESUMO
Summary: New sputum negative (NSN) tuberculosis case detection in Jalpaiguri district has been consistently low. Availability and accessibility of health facilities with chet x-rays is key for the diagnosis of NSN cases. To identify factors associated with utilisation of x-ray facilities in the district, we interviewed 4,875 chest symptom&tics who were sputum negative on two occasions with an antibiotics course in between. Chest radiography was available in only three public health facilities in the district. Low income, long distance from the public health facilities with chest radiography and high cost of x-rays at private hospitals were key factors associated with symptomatics not undergoing X-ray. It is necessary to increase facilities for radiological diagnosis and provide mobility support for the symptomatics in Jalpaiguri.