Utility Of Cartridge Based Nucleic Acid Amplification Test (cbnaat) In The Diagnosis Of Tubercular Pleural Effusion

ABSTRACT

Introduction: TB is one of the top 10 causes of death globally. PTB is most common presentation. Lymph node TB is the most common type of EPTB constitutes about 35% cases followed by pleural effusion(20%), bone and joint(10%), genitourinary TB(9%), TB Meningitis(5%), abdominal tuberculosis(3%), other(10%). WHO also recommends Gene Xpert MTB/RIF over conventional tests which permits rapid TB diagnosis through detection of the genetic sequence of DNAof mycobacterium TB and simultaneous identification of a majority of the mutations that confirm Rifampicin resistance which is highly predictive of MDR-TB. Methodology: Study was carried out over a period of one year in a tertiary care centre. Patients with suggestive of pleural effusion were included in study. Pleural fluid was drawn using standard protocol and sent for CBNAAT test and bacteriological examination. Based on MTB result, the study population were divided into 'MTB detected' and 'MTB not detected' groups. MTB detected group was further divided into 'Rif' Resistant and 'Rif' sensitive group. All the collected information was filled in predesigned proforma in excel sheet for final analysis. Chi squire test or suitable formula was applied to know the significance of our study. Results: 203 patients were included with a male to female ratio of 2.981. 65.91% patients were below 45 years of age. Mostly patients were from rural areas and illiterate. 38.64% had different type of substance abuse habit. DM (29.03%) found as the most common co-morbidities. CBNAAT test was able to detect MTB in 76 (37.44%) extra-pulmonary samples, 70 were Rifampicin sensitive and 6 were 'Rifampicin' resistant.