scholarly journals The silent pandemic in South Africa: Extra-pulmonary tuberculosis from head to heel

2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Camilla E. Le Roux ◽  
Sucari S.C. Vlok
Keyword(s):  
South Africa ◽  
Mycobacterium Tuberculosis ◽  
Pulmonary Tuberculosis ◽  
Communicable Disease ◽  
Diagnostic Dilemma ◽  
Extra Pulmonary Tuberculosis ◽  
Immunodeficiency Virus ◽  
Normal Chest Radiograph ◽  
Normal Chest ◽  
Extra Pulmonary

Extra-pulmonary tuberculosis (EPTB), caused by Mycobacterium tuberculosis, is the leading cause of communicable disease-related deaths in people with human immunodeficiency virus (HIV) worldwide and in South Africa. Mycobacterium tuberculosis disseminates haematogenously from an active primary lung focus and may affect extra-pulmonary sites in up to 15% of patients. Extra-pulmonary TB may present with a normal chest radiograph, which often causes a significant diagnostic dilemma. This review describes the main sites of involvement in EPTB, which is illustrated by local imaging examples.

scholarly journals 1633. Improving the diagnosis of extra-pulmonary tuberculosis (EPTB): experience from north India

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S808-S808
Author(s):  
Anchal Sharma ◽  
Kusum Sharma ◽  
Manish Modi ◽  
Aman Sharma
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Pulmonary Tuberculosis ◽  
Mycobacterium Tuberculosis Complex ◽  
Lamp Assay ◽  
Nucleic Acid Amplification ◽  
Rural Setting ◽  
Tuberculosis Complex ◽  
Extra Pulmonary Tuberculosis ◽  
Resource Poor ◽  
Extra Pulmonary

Abstract Background Rapid and accurate diagnosis of extra-pulmonary tuberculosis (EPTB) is imperative for early treatment and better patient outcome. Loop-mediated Isothermal Amplification (LAMP) is a promising nucleic-acid amplification assay. LAMP assay could be carried out in simple water bath under isothermal conditions in 60 minutes, and can be performed in any laboratory even in rural setting in resource poor endemic countries. We evaluated LAMP assay using two different target regions LAMP primers specific for Mycobacterium tuberculosis complex for the diagnosis of EPTB. Methods LAMP assay using 6 primers (each for IS6110 and IS1081) specific for Mycobacterium tuberculosis complex were performed on patients suspected of EPTB on various EPTB samples(CSF, Synovial fluid, Lymaphnode and tissue biopsies and various other samples) of 150 patients (50 confirmed, 100 suspected) Clinically suspected of EPTB and 100 non-TB control subjects. Results Overall LAMP test (using any of the two targets) had sensitivity and specificity of 96% and 100% for confirmed (50 culture positive) EPTB cases. In 100 clinically suspected but unconfirmed EPTB cases, LAMP was positive in 87 out of 100 cases (87%). Sensitivity of IS6110 LAMP, 1S1081 LAMP and IS6110 PCR for clinically suspected cases was 78 (78%), 84 (84%) and 70 (70%), respectively. In total 150 EPTB patients, the overall sensitivity of microscopy, culture, IS6110 PCR, IS6110 LAMP, 1081 LAMP and the LAMP test (if any of the two targets were used) were 4%, 33.3%, 74.6%, 82.66%, 87% and 92%, respectively. Specificity of all the tests was 100%. There were 8 cases which were missed by IS6110 LAMP and 2 cases by 1081 LAMP. Conclusion LAMP assay using two targets is a promising technique for rapid diagnosis of EPTB in 60 minutes especially in a resource poor setting who are still battling with this deadly disease. Disclosures All Authors: No reported disclosures

scholarly journals Anti- cyclic citrullinated peptide antibodies in tuberculosis and human immunodeficiency virus

2020 ◽  
Vol 7 (5) ◽  
pp. 804
Author(s):  
Rakesh K. Yadav ◽  
Raj K. ◽  
Kachnar V. ◽  
Manoj K. Mathur ◽  
Amitabh D. Shukla
Keyword(s):  
Rheumatoid Arthritis ◽  
Human Immunodeficiency Virus ◽  
Virus Infection ◽  
Pulmonary Tuberculosis ◽  
Infectious Diseases ◽  
Human Immunodeficiency Virus Infection ◽  
Extra Pulmonary Tuberculosis ◽  
Immunodeficiency Virus ◽  
Extra Pulmonary ◽  
Citrullinated Peptide

Background: Anti-cyclic citrullinated peptide (anti-CCP) antibodies have been considered very specific for rheumatoid arthritis (RA). Some studies have shown that these antibodies can be positive in infectious diseases like tuberculosis, human immunodeficiency virus infection, etc.Methods: Eighty patients of tuberculosis both pulmonary and extra-pulmonary tuberculosis and thirty patients of human immunodeficiency virus were enrolled in this study from inpatient and outpatient departments from September 2018 to August 2019. Anti-CCP antibody test was done in all the patient by enzyme linked immunosorbent assay.Results: Fifty-three patients were of pulmonary tuberculosis, 27 patients were extra-pulmonary tuberculosis and 30 patients were human immunodeficiency virus infection. Of the 53 cases of pulmonary tuberculosis, 21 (39.6%) cases were positive for anti-CCP antibodies and 32 (60.4%) cases were negative for the same. Of the 27 cases of extra-pulmonary tuberculosis, 3(11.1%) cases were positive for anti-CCP antibodies and 24 (88.9%) cases were negative. Of the 53 patients of pulmonary tuberculosis, 16 were sputum positive and 37 were sputum negative. Of those withsputum positive 9 (56.2%) cases were positive for anti-CCP antibodies and those with sputum negative, 12 (32.4%) cases were positive for anti-CCP antibodies. Of the 30 cases of human immunodeficiency virus, 5 (16.7%) cases were positive for anti-CCP antibodies and 25 (83.3%) cases were negative.Conclusions: Anti-CCP can be positive in cases of infectious diseases like tuberculosis and human immunodeficiency virus. Positivity of anti-CCP antibodies for tuberculosis is more for pulmonary (more for sputum-positive than sputum-negative) than extra-pulmonary tuberculosis. Anti-CCP, thus is not very specific for rheumatoid arthritis.

scholarly journals Gen X-Pert MTB/Rif Assay with the Ziehl Nielsen, and Florescence Microscopy Detection Rate of Urinary Tuberculosis Among Suspected and Pulmonary MTB Positive Patients Visiting University of Gondar Specialized Referral Hospital, Northwest Ethiopia.

2021 ◽  
Author(s):  
Dessie Eshetie ◽  
Minichil Worku ◽  
Abiye Tigabu ◽  
Melak Aynalem ◽  
Nega Berhane
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Urinary Tract ◽  
Fluorescence Microscopy ◽  
Pulmonary Tuberculosis ◽  
Detection Rate ◽  
Extra Pulmonary Tuberculosis ◽  
Extra Pulmonary ◽  
Urinary Tuberculosis ◽  
Study Participants ◽  
Gen X

Abstract Background Tuberculosis is a bacterial infection caused by Mycobacterium tuberculosis remains a major global public health concern. Extra-pulmonary tuberculosis accounts for 15% of the global tuberculosis burden. Urinary tract tuberculosis is one of the most common and severe forms of extra-pulmonary tuberculosis in clinical practice. Diagnosis of urinary tract tuberculosis by Gen X-pert MTB/RIF assay from developing countries including Ethiopia is limited. Thus, this study was aimed to compare Gene X-pert MTB/RIF assay with the convectional diagnosis methods. Methods A hospital-based cross-sectional study was conducted among confirmed pulmonary tuberculosis and suspected for urinary tract tuberculosis patients at University of Gondar Specialized Referral Hospital from February 2020 to June 2020 G.C. Non-randomized purposive sampling technique was used to select study participants. To detect Mycobacterium tuberculosis, a urine sample was collected. Then, Ziehl Nielsen and fluorescence microscope, Gene X-pert Real-time PCR were performed to detect the Mycobacterium tuberculosis. Sociodemographic, clinical data, and laboratory data were collected and entered into EPI-Info version 3.5.3 and then transferred to SPSS version-20 for analysis. Descriptive statistics were summarized as percentages, means, and standard deviations. Results A total of 64 study participants were enrolled in this study, 64.2% (41/64) were males and 30% (19/64) were in the age group of 31–45 years. Moreover, 71.9% (46/64) and 57.8% (37/64) study participants were rural residences and illiterate respectively. Among the 64 study participants, 4.69% (3/64) were positive for urinary tuberculosis by Gene X-expert. However, 1.56% (1/64) was positive by fluorescence microscopy, and there was no urinary tuberculosis detected by Ziehl Nielsen examination method. Conclusion and recommendation: The prevalence of urinary tract Mycobacterium tuberculosis using Gene X-pert and fluorescence microscopy was 4.69% (3/64) and 1.56% (1/64), respectively. Gene X-pert has higher detection rate than the conventional methods. Therefore, it is better to develop a guideline on how to use Gen x-pert for the diagnosis for urinary tract tuberculosis in urine samples.

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