scholarly journals Diagnostic Performance of Xpert MTB/RIF Assay Versus Ziehl-Neelsen Method for the Diagnosis of Pulmonary Tuberculosis in Addis Ababa, Ethiopia

2018 ◽  
Vol 12 (1) ◽  
pp. 390-396
Author(s):  
Boja D. Taddese ◽  
Daniel M. Desalegn ◽  
Abay S. Misganaw ◽  
Kumera T. Kitila ◽  
Tinsae Kidanemariam Hailu ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Predictive Value ◽  
Gold Standard ◽  
Addis Ababa ◽  
Public Health Problem ◽  
Sputum Smear ◽  
Smear Microscopy ◽  
Sputum Smear Microscopy ◽  
Cross Sectional ◽  
Sensitivity Specificity

Background: Worldwide Tuberculosis (TB) is the ninth leading cause of death from a single infectious agent, positioning on top of Human Immuno Deficiency Virus (HIV) and it is still an eminently serious public health problem. In developing countries, Ziehl-Neelsen (ZN)-stained sputum smear microscopy is the most widely used diagnostic method in diagnosing Pulmonary Tuberculosis (PTB). This study was aimed to compare the diagnostic performances of ZN-method with Xpert MTB/RIF assay for the diagnosis of PTB in Addis Ababa, Ethiopia. Methods: Facility-based cross-sectional study design was conducted from September 2016 to June 2017 on a total of 244 sputum samples collected from presumptive TB patients. The L-J sputum culture was used as a gold standard to compare the diagnostic performances of Xpert MTB/RIF assay and ZN-methods. Kappa values were analyzed by using statistical package for Social Science (SPSS) version 20 software at 95% Confidence Interval (CI). The Sensitivity, Specificity, Positive Predictive Value (PPV) and Negative Predictive Value (NPV) of ZN-stained sputum smear microscopy and Xpert MTB/RIF assay were calculated against the gold standard. Results: The Sensitivity, Specificity, PPV and NPV of ZN-stained sputum smear microscopy were 68.38%, 95.28%, 93.02% and 76.58% respectively, while for Xpert MTB/ RIF assay were 88.89%, 81.89%, 81.89% and 88.89% respectively. The results of the two diagnostic approaches were concordant with the gold standard with a kappa value of ZN 0.650 and 0.743 for Xpert MTB/RIF assay. Conclusion: This study concludes that the sensitivity of Xpert MTB/RIF assay was better than ZN-stained direct sputum smear microscopy for the diagnosis of pulmonary tuberculosis.

scholarly journals Performance of LED Fluorescence Microscopy for the Diagnosis of Pulmonary Tuberculosis in HIV Positive Individuals in Addis Ababa, Ethiopia

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Konjit Getachew ◽  
Tamrat Abebe ◽  
Abebaw Kebede ◽  
Adane Mihret ◽  
Getachew Melkamu
Keyword(s):  
Pulmonary Tuberculosis ◽  
Predictive Value ◽  
Addis Ababa ◽  
Sputum Sample ◽  
Cross Sectional Study ◽  
Hiv Positive ◽  
Smear Microscopy ◽  
Lower Sensitivity ◽  
Cross Sectional ◽  
Sensitivity Specificity

Background. Despite its lower sensitivity, smear microscopy remains the main diagnostic method for pulmonary tuberculosis (PTB) in resource-limited countries as TB culturing methods like LJ (Lowenstein-Jensen) are expensive to use as a routine base. This study aimed to evaluate the performance of LED-FM for the diagnosis of PTB in HIV positive individuals.Methods. Cross-sectional study was conducted in Zewditu Memorial Hospital and Teklehaimanot Health Center HIV/ART clinics in Addis Ababa, Ethiopia. Each sample was stained with ZN and Auramine O staining and examined with bright-field microscope and LED-FM microscope, respectively. LJ culture was used as a reference.Results. Out of 178 study participants, twenty-four (13.5%) patients were confirmed as positive for MTB with LJ culture. The yield of ZN microscopy and LED-FM in direct and concentrated sample was 3.9%, 8.4%, 6.2%, and 8.4%, respectively. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of direct ZN microscopy were 29.2%, 100%, 100%, and 90.1%, respectively, and of LED-FM microscopy in direct sputum sample were 62.5%, 100%, 100%, and 94.5%, respectively.Conclusion. LED-FM has better sensitivity for the diagnosis of PTB in HIV positive individuals as compared to conventional ZN microscopy. LED-FM can be used as an alternative to conventional ZN microscopy.

scholarly journals Sputum Smear Positive Pulmonary Tuberculosis Diagnostic Dropout Rate in Public Health Facilities, Addis Ababa, Ethiopia

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Daniel Melese Desalegn ◽  
Kumera Terfa Kitila ◽  
Boja Dufera Taddese ◽  
Tinsae Kidanemariam Hailu ◽  
Tariku Takle Dinku ◽  
...  
Keyword(s):  
Public Health ◽  
Pulmonary Tuberculosis ◽  
Addis Ababa ◽  
Dropout Rate ◽  
Sputum Smear ◽  
P Value ◽  
Smear Microscopy ◽  
Sputum Smear Microscopy ◽  
Public Health Facilities ◽  
Smear Positive Pulmonary Tuberculosis

Background. Prolonged laboratory diagnostic process of tuberculosis can lead to failure to complete the diagnosis and increase dropout rate of smear positive pulmonary tuberculosis (PTB) cases. This implies such dropout patients without completing diagnosis are critical as infected individuals remain untreated in the community, providing more opportunities for transmission of the disease and adversely affecting the epidemic. The aim of this research is to determine the level of smear positive PTB diagnosis dropout rate of spot-morning-spot sputum microscopy diagnosis method in public health facilities, in Addis Ababa, Ethiopia. Methods. Retrospective review of patient documents in 13 public health facilities’ TB laboratory in Addis Ababa was conducted from October 2011 to March 2016. Data was computerized using Epi-info software and analysed using SPSS version 20.0 software. Descriptive numerical summaries were used to present the findings. Association between the dropout rate and demographic variables was assessed by Chi-square (X2). Bivariate model using Odds Ratio (OR) with a 95% Confidence Interval (CI) was calculated. P-Value less than 0.05 was taken as statistically significant. Results. Of 41,884 presumptive TB patients registered during the 53 months for laboratory investigation, 5.9% were positive for the first spot sputum smear microscopy. Among these positive cases, 142 (5.8%) and 298 (12.1%) did not come back to the laboratory to submitted early morning and second spot sputum specimens, respectively. The diagnostic dropout for morning sputum specimen in hospitals was 5.6% (58/1039) and in health centres was 5.9% (84/1424). However, higher proportion of dropout for second spot sputum specimen in hospitals was 16.4% (170/1039), compared to the health centres, 8.9% (128/1424). Diagnostic dropout of sputum smear microscopy had no significant association with sociodemographic variable (P value >0.05), while it had significant association with facility type (P value <0.05). Conclusion. In this study smear positive pulmonary tuberculosis diagnostic dropout rate was high compared to WHO reported for the new strategy shift implying the importance of shifting to same-day approach. Hence, shifting from conventional to same day is crucial to minimize the TB diagnostic dropout rate in the study area and other similar settings. Further research is needed/recommended in the local setting to compare the yield and dropout rates between same-day and conventional sputum smear microscopy approach.

scholarly journals Comparison of Auramine Phenol and ZN Staining in Diagnosis of Pulmonary Tuberculosis with GeneXpert MTB/RIF as Gold Standard

2020 ◽  
Vol 9 (3) ◽  
pp. 190-194
Author(s):  
Naureen Saeed ◽  
Fatima-tuz-zuhra ◽  
Nadeem Ikram ◽  
Farhana Shaukat ◽  
Fareeha Sardar
Keyword(s):  
Pulmonary Tuberculosis ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Gold Standard ◽  
Sputum Sample ◽  
False Negative ◽  
Smear Microscopy ◽  
Predictive Values ◽  
Pulmonary Tb ◽  
Sensitivity Specificity

Background: Pakistan faces an immense burden of pulmonary tuberculosis (TB) due to large number of cases and limited resources. Despite the recent advancement in the diagnostic techniques for pulmonary TB, smear microscopy is still a useful technique for the diagnosis of this disease. This study was conducted in order to compare the diagnostic value of Auramine stain with the conventional Ziehl-Neelsen (ZN) stain on the sputum smear for the diagnosis of pulmonary TB, keeping GeneXpert MTB/RIF as the gold standard. Method: This cross-sectional study was conducted on 356 suspected patients of pulmonary TB referred to the Pathology laboratory from TB ward and OPD of District Head Quarter (DHQ) teaching hospital Rawalpindi, Pakistan. Sputum specimen were collected and two smears were prepared from each sputum sample on which Auramine phenol and Ziehl-Neelsen staining were carried out as per WHO recommendations. All these samples were further tested using Gene Xpert MTB/RIF technique. The sensitivity, specificity, Positive predictive value (PPV) and Negative predictive values (NPV) of ZN and Auramine stain were calculated and compared with GeneXpert MTB/RIF technique. Results: Out of the total 356 samples, 64(18%) were positive and 291(82%) were negative by GeneXpert which was taken as the gold standard. On comparison with GeneXpert, percentage of true positive was greater in case of Auramine than ZN stained samples (16.29% versus 12.92%), while the percentage of false positive was same for both staining techniques (0.28%). There were lesser false negative cases observed in samples stained by Auramine as compared to the ones stained by ZN (1.68% versus 5.05%). The sensitivity, specificity, positive predictive value and negative predictive values were 97.87%, 94.17%, 71.88 and 99.66%, respectively for the ZN staining and 98.31%, 97.98%, 90.63% and 99.66% respectively, for the Auramine phenol staining. Conclusion: Smear microscopy using Auramine phenol stain is a useful technique for the diagnosis of pulmonary TB. The Auramine phenol staining with fluorescent microscopy is found to be superior to ZN staining because of higher sensitivity and specificity. Keywords: Auramine phenol, Fluorescence microscopy, GeneXpert, Mycobacterium tuberculosis, Ziehl-Neelsen

scholarly journals RELATIONSHIP BETWEEN SUCCESSFUL TREATMENT OF PULMONARY TUBERCULOSIS PATIENTS WITH THE AVAILABILITY OF TREATMENT SUPPORTER IN ATMA JAYA HOSPITAL

2019 ◽  
Vol 18 (2) ◽  
pp. 67-73
Author(s):  
Fariz Abdul Mujib Dailami ◽  
Regina Satya Wiraharja ◽  
Febie Chriestya
Keyword(s):  
Pulmonary Tuberculosis ◽  
Successful Treatment ◽  
World Health ◽  
Sputum Smear ◽  
Smear Microscopy ◽  
Fisher Exact Test ◽  
Sputum Smear Microscopy ◽  
Cross Sectional ◽  
Exact Test ◽  
Tb Treatment

Introduction: One of the biggest health problems faced by community is pulmonary tuberculosis (TB).TB is an respiratory tract infectious disease caused by Mycobacterium Tuberculosis. World Health Organization (WHO) recommends TB treatment with Directly Observed Treatment Short-course (DOTS) strategy, one of which is through the help of treatment supporter (PMO or Pengawas Minum Obat) who supervises the patient during the treatment period. Methods: This was an analytic descriptive study with cross sectional approach.. Respondents were taken by consecutive sampling, based on medical records at Atma Jaya Hospital. We applied inclusion criteria such as newly diagnosed TB patient with positive sputum smear microscopy results, adult TB patient who has finished 6 month of treatment and patients who have done sputum smear microscopy test after finishing their TB treatment. The exclusion criteria were TB-HIV patients and Milliary TB patients. After fulfilment of those criteria, a total of 81 respondents were selected. Data was analysed by Chi Square test (Fisher Exact test). Results: Most of patients were 15-50 years old (70,4%) with mean age at 38.49±17.83 years old),male (53.1%), had family as treatment supporter (91.4%) and had successful TB treatment (74.1%). TB patients with treatment supporter had more successful treatment (66.7%) than TB patients with no treatment supporter (7.4%), however there was no significant among the avalibility of treatment supporter and the success of TB treatment (p=0.670). Conclusion: Despite the insignificant result, this study gives good insight to implementation of TB DOTS strategy in Atma Jaya Hospital. The implementation of this strategy contributes to imbalance number of samples between patient with and without treatment supporter, leading to overestimate results on with TB treatment supporter group.

scholarly journals Clinical impact and cost analysis of the use of either the Xpert MTB Rif test or sputum smear microscopy in the diagnosis of pulmonary tuberculosis in Rio de Janeiro, Brazil

2018 ◽  
Vol 51 (5) ◽  
pp. 631-637
Author(s):  
Anália Zuleika de Castro ◽  
Adriana Rezende Moreira ◽  
Jaqueline Oliveira ◽  
Paulo Albuquerque Costa ◽  
Carolyne Lalucha Alves Lima Da Graça ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Cost Analysis ◽  
Rio De Janeiro ◽  
Clinical Impact ◽  
Sputum Smear ◽  
Smear Microscopy ◽  
Sputum Smear Microscopy

scholarly journals Association between Xpert MTB/RIF cycle threshold values and sputum smear microscopy in patients with pulmonary tuberculosis

2021 ◽  
pp. e20200549
Author(s):  
Gabriela Carpin Pagano1 ◽  
Giovana Rodrigues Pereira1,2 ◽  
Karen Gomes D'Ávila3 ◽  
Luciana Rott Monaiar3 ◽  
Denise Rossato Silva1,3,4
Keyword(s):  
Pulmonary Tuberculosis ◽  
Sputum Smear ◽  
Smear Microscopy ◽  
Threshold Values ◽  
Sputum Smear Microscopy ◽  
Cycle Threshold

Blinded Rechecking of AFB smear Microscopy performance in Selected private health facilities in Tigray, Northern Ethiopia

2020 ◽  
Author(s):  
Letebrhan Weldemhret
Keyword(s):  
Predictive Value ◽  
Cost Effective ◽  
Cross Sectional Study ◽  
Health Facilities ◽  
Sputum Smear ◽  
Smear Microscopy ◽  
Northern Ethiopia ◽  
Major Error ◽  
Cross Sectional ◽  
Tigray Region

Abstract Background: Sputum smear microscopy remains the most cost-effective tool for tuberculosis diagnosis and treatment monitoring in resource constrained settings. Random blinded rechecking is a reliable tool to measure and improve smear microscopy. So, this study was intended to assess random blinded rechecking of AFB smear microscopy performance in selected private health facilities in Tigray region, Northern Ethiopia.Methods: A cross sectional study was conducted from April 1st 2017 to May 30, 2017. The data was collected using standard data collection form. Statistical analysis was done using SPSS version 25 and the reading agreement was done using kappa statistics.Results: Of the total 269 blinded rechecked smears, 4.8% was found discrepant findings. The major and minor errors were reported by 2.6% (7/269) and 2.2% (6/269) respectively. Likewise, the major error was reported by 50% (5/10) of health facilities with microscopic center. Overall, the sensitivity, specificity, positive predictive value, and negative predictive value of the blinded rechecking smears were 87.5%, 98%, 89.7% and 97.8%, respectively with substantial reading agreement, kappa value= 0.80.Conclusions: The overall performance of blinded rechecking was satisfactory with good smear reading agreement. But, the major error reported indicated unacceptable performance. To minimize the discrepancy, private health facilities with tuberculosis smear microscopic center should adhere to national tuberculosis guidelines.

scholarly journals Optimising fluorescein diacetate sputum smear microscopy for assessing patients with pulmonary tuberculosis

PLoS ONE ◽  
2019 ◽  
Vol 14 (4) ◽  
pp. e0214131 ◽  
Author(s):  
Sumona Datta ◽  
Keren Alvarado ◽  
Robert H. Gilman ◽  
Teresa Valencia ◽  
Christian Aparicio ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Fluorescein Diacetate ◽  
Sputum Smear ◽  
Smear Microscopy ◽  
Sputum Smear Microscopy

scholarly journals Effectivity of microscopic test as a simple diagnostic method to detect fat malabsorption in children

2019 ◽  
Vol 28 (4) ◽  
pp. 338-44
Author(s):  
Ariani Dewi Widodo ◽  
Muzal Kadim ◽  
Ina Susianti Timan ◽  
Nuraini Irma Susanti ◽  
Fatima Safira Alatas ◽  
...  
Keyword(s):  
Predictive Value ◽  
Gold Standard ◽  
Diagnostic Study ◽  
Normal Children ◽  
Cross Sectional ◽  
Primary Endpoints ◽  
Sudan Iii ◽  
Fat Malabsorption ◽  
Moderate Sensitivity ◽  
Sensitivity Specificity

BACKGROUND Lipid malabsorption causes many health problems, for example stunting, a major worldwide issue. There has not been any assessment on the effectivity of lipid microscopic test in diagnosing lipid malabsorption. This research was aimed to study the effectivity of lipid microscopic test in detecting lipid malabsorption in children. METHODS This was a cross-sectional diagnostic study that evaluated the effectivity of lipid microscopic test using Sudan III against steatocrit test as the gold standard in diagnosing lipid malabsorption. The study was done in 68 children aged 6–60 months in Cipto Mangunkusumo Hospital, Jakarta. Results of lipid microscopic test were compared with that of steatocrit test among children with lipid malabsorption and normal children. The primary endpoints of this study are the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). RESULTS A total of 68 children consisting of 41 boys and 27 girls were included, with a median age of 14.3 months. The most frequently found stool consistency was mushy (50%). The most common result of microscopic test, found in 42% of subjects, was positive 1. Sensitivity, specificity, PPV, and NPV of lipid microscopic test were 49.15%, 66.67%, 90.63%, and 16.67%, respectively. CONCLUSIONS Lipid microscopic test has a moderate sensitivity in diagnosing fat malabsorption and needs to be complemented with other methods such as steatocrit.

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