Sputum smear microscopy for the diagnosis of tuberculosis (TB) is cheap and simple but its sensitivity is low. Culture on Löwenstein-Jensen (LJ) is more sensitive but it takes a long time to yield results. Thin-Layer Agar (TLA) culture was suggested as an equally sensitive and faster alternative. We evaluated the performance of TLA for diagnosing TB in Jogjakarta, Indonesia. People with suspected TB presenting from July 2010 to July 2011 to two chest clinics of the National TB Control Programme network of Jogjakarta were eligible for inclusion. A sputum sample was sent to the Gadjah Mada University microbiology laboratory for concentration, smearing, Ziehl-Neelsen staining and culture on LJ and TLA. Sensitivity of cultures was evaluated against a composite reference standard (any positive culture). Time to detection of Mycobacteria was recorded. Out of 1414 samples, 164 (12%) were smear positive, 99 (7%) were scanty and 1151 (81%) were negative. On TLA and LJ respectively, 168 (12%) and 149 (11%) samples were positive, 72 (5%) and 32 (2%) were contaminated (κ = 0.64; 95% CI 0.59-0.69, p <0.01). Using the reference standard, 196 (14%) TB cases were identified. The sensitivity of TLA was 0.86 (95% CI 0.80-0.90), significantly higher (p 0.03) than for LJ (0.76; 95% CI 0.69-0.81). The median time to detection in days was significantly shorter (p <0.01) for TLA (12; 95% CI 11-13) than for LJ (44; 95% CI 43-45). TLA is a rapid and sensitive method for the diagnosis of TB. Implementation studies to evaluate the cost-effectiveness and impact of its introduction into programmatic settings are urgently needed.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1111/1469-0691.12265 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Macrophage Activation Syndrome in a Patient with Systemic Lupus Erythematous Triggered by Tuberculous Meningitis.
Eur J Case Rep Intern Med
December 2024
Internal Medicine, Dubai Health, Dubai, United Arab Emirates.
Background: Hemophagocytic lymphohistiocytosis (HLH), is characterized by systemic uncontrolled inflammation resulting from immune dysregulation secondary to various triggers, including genetics, infections, autoimmune diseases, and malignancies. Macrophage activation syndrome (MAS) is an immune dysregulation phenomenon, in which an underlying rheumatological disease is present. We report a rare, interesting case of a middle-aged female, with a systemic lupus erythematosus (SLE) flare complicated by macrophage activation syndrome (MAS), in which tuberculous meningitis (TBM) was the identified trigger.
View Article and Find Full Text PDFDistribution of extrapulmonary tuberculosis in CBNAAT samples received in a tertiary care hospital - A record-based study.
J Family Med Prim Care
December 2024
Department of Microbiology, College of Medicine and Sagore Dutta Hospital, Kolkata, West Bengal, India.
Background: Pulmonary tuberculosis (PTB) accounts for 85% of all reported tuberculosis cases globally. Extrapulmonary involvement can occur in isolation or along with a pulmonary focus as in the case of patients with disseminated tuberculosis (TB). EPTB can occur through hematogenous, lymphatic, or localized bacillary dissemination from a primary source, such as PTB and affects the brain, eye, mouth, tongue, lymph nodes of neck, spine, bones, muscles, skin, pleura, pericardium, gastrointestinal, peritoneum and the genitourinary system as primary and/or disseminated disease.
View Article and Find Full Text PDFDisseminated tuberculosis masquerading as a psychiatric illness-A case report.
J Family Med Prim Care
December 2024
Department of Medicine, Universiti Teknologi MARA, Puncak Alam, Malaysia, Asia.
Unlabelled: Tuberculosis (TB) can affect any organ, and at times more than one organ in any sequence, in which case it is referred to as disseminated tuberculosis (DTB). We report a patient who presented primarily for psychiatric symptoms of three months' duration, which later turned out to be a case of DTB involving the central nervous system as well as the spine and lungs.
Case Presentation: An elderly lady with subacute onset and worsening behavioural changes of three months' duration was referred for exclusion of organic brain disease.
Pulmonary tuberculosis presenting with tubercular myocarditis and shock in an adolescent child.
J Family Med Prim Care
December 2024
Department of Pediatrics, PGIMS, Rohtak, Haryana, India.
Involvement of the heart in children with tuberculosis (TB) generally affects the pericardium; however, the myocardium of a child being affected alone and leading to systolic heart dysfunction has rarely ever been reported. We report a case of a 12-year-old child who presented to Pediatric Emergency Services with severe hypotension (BP <5 percentile for the age) and was subsequently diagnosed with severe left ventricular (LV) dysfunction, with an ejection fraction of less than 15%. During the hospital stay, after an exhaustive workup, the child was diagnosed with pulmonary TB with tubercular myocarditis.
View Article and Find Full Text PDFRisk of Lung Cancer and Risk Factors of Lung Cancer in People Infected with Tuberculosis.
J Cancer Prev
December 2024
Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Korea.
This study investigated lung cancer risk in people infected with tuberculosis (TB) compared to the general population and evaluated factors associated with lung cancer in TB-infected individuals. Mandatory reported TB infection case data in Gyeonggi Province, South Korea (2010 to 2016) were obtained and linked with medical usage and health screening data from the National Health Information Database. Lung cancer incidence in patients with TB was compared to that in the general population using standardized incidence ratio (SIR), adjusted for age and sex.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!