To Compare the Competency of Prognostic Markers- ESR, CRP against ZN Staining in Determining Pulmonary Tuberculosis Cases

ABSTRACT

Background: Tuberculosis (TB) is a highly prevalent chronic infectious disease caused by Mycobacterium tuberculosis an aerobic intracellular binding bacterium (bacillus). Active TB disease can be fatal if left untreated. The disease today is considered curable and preventable. This retrospective study was undertaken to compare and analyzed the relationship between acute phase reactant proteins CRP (quantitative) and ESR in sputum smear positive for AFB patients and to evaluate their diagnostic and prognostic significance. Methods: The present prospective study was carried on a randomly selected study group comprising of 180 cases of pulmonary TB patients who were sputum smear positive for AFB and 25 normal healthy (sputum smear negative for AFB) individual were taken as control. The cases of  PTB group was further categorized on the basis of recommendation of RNTCP grading system of AFB in Sputum ZN staining into four subgroups AFB – 3+, AFB – 2+, AFB –1+ and scanty. The control groups were negative for the Acid Fast bacilli in sputum. Results: In our study showed that the maximum patients seen in grade III (36.11%) followed by grade II (31.66%), grade I (19.44%) and 12.77% scanty according to RNTCP grading system of ZN staining of sputum for acid fast bacilli.  The   distribution of mean values of CRP, ESR in different grades of ZN staining of sputum in AFB positive patients as well as controls. CRP mean value was 55.4, 40.8 & 22.9 in grade III, grade II & grade I respectively and ESR was 48.1, 38.8 & 23 respectively in different grading significantly higher (p vol < 0.0001) in group II there were no serious adverse reactions in either group. Conclusions: Our study concluded that during the compression of values of CRP and ESR along with the grading of sputum AFB positive patients, the CRP raised more significantly as compare to ESR; with markedly raised values in all the grades of sputum AFB positive patients.