scholarly journals Cartridge Based Nucleic Acid Amplification Test: Utility as Diagnostic Modality in Clinically Diagnosed Childhood Tuberculosis

2020 ◽  
Author(s):  
Rajesh Kumar Yadav ◽  
Durgesh Kumar ◽  
Yogendra Singh Yadav ◽  
Dinesh Kumar Singh ◽  
Amit Singh ◽  
...  
Keyword(s):  
Nucleic Acid ◽  
Diagnostic Test ◽  
Nucleic Acid Amplification Test ◽  
Nucleic Acid Amplification ◽  
Mantoux Test ◽  
P Value ◽  
Suspected Case ◽  
Gastric Aspirate ◽  
Csf Analysis ◽  
Conventional Methods

Introduction: Tuberculosis (TB) remains one of the deadliest communicable diseases worldwide. The introduction of early and rapid diagnostic test such as Cartridge Based Nucleic Acid Amplification Test (CBNAAT) creates opportunities for improvement in early and fast detection of TB and drug-resistance. Aim: To determine the prevalence of Tubercular cases in clinically diagnosed TB patients and to determine the prevalence of Rifampicin resistance by CBNAAT. Materials and Methods: This prospective observational study involved a total of 107 children from January 2018 to June 2019, fulfilling the inclusion criteria who were clinically diagnosed and found positive in conventional tests for TB. CBNAAT was used to confirm Mycobacterium tuberculosis (MTB) for the diagnosis of childhood TB and compare with other conventional methods. Chi-square test for the proportion was applied and p-value <0.05 taken as significant. Results: Of the 107 patients studied, 44.9% were female and 55.1% were male. The age range was 3 months to 12 years. The cases were confirmed by CBNAAT in clinically suspected case of TB was found to be 17.8% (19 cases out of 107 patients). CBNAAT was able to detect MTB in 14% (15 cases out of 107 patients) of the gastric aspirate/sputum sample. Out of 107 patients, 69 children were clinically diagnosed as Neurotuberculosis and 13% (9 out of 69 cases) cases were confirmed by CBNAAT in Cerebrospinal Fluid (CSF). OF which 29 patients had CSF analysis suggestive of Tubercular Meningitis (TBM). Out of 29 patients, 10 (34.5%) cases were confirmed by CBNAAT. This test showed a significant association with positive Mantoux test (p-value 0.020) and CSF analysis (p-value 0.021) suggestive of TBM. Conclusion: CBNAAT should be used in preference to conventional methods as the initial diagnostic test for patients suspected of having TB. CBNAAT positivity shows significant association with positive Mantoux test and CSF analysis suggestive of TBM.

scholarly journals Prospective study to find out the role of gastric aspirate examination by Ziehl-Neelsen staining (ZN staining) and cartridge based nucleic acid amplification test (CB-NAAT) as a diagnostic method in childhood tuberculosis

2018 ◽  
Vol 5 (4) ◽  
pp. 1609
Author(s):  
Akansha Arora ◽  
Anil Jain ◽  
B. S. Karnawat ◽  
Rakesh Kumawat
Keyword(s):  
Nucleic Acid ◽  
Predictive Value ◽  
Nucleic Acid Amplification Test ◽  
Nucleic Acid Amplification ◽  
Mantoux Test ◽  
P Value ◽  
Specific Method ◽  
Gastric Aspirate ◽  
Tuberculosis In Children

Background: Tuberculosis in children has been relatively neglected mainly because clinical diagnosis has low specificity, radiological interpretation is subject to inter-observer variability and the tuberculin skin test is a marker of exposure, not disease. The recent introduction of Cartridge based nucleic acid amplification test has significantly transformed the diagnostics of tuberculosis in adults but its application for Paediatric Tuberculosis is under evaluation. Therefore, authors conducted a study on role of gastric aspirate examination by ZN stain and Cartridge based nucleic acid amplification test in the diagnosis of childhood Tuberculosis.Methods: Authors did a prospective hospital-based study from Nov 2016 to Nov 2017 consisting of 100 randomly selected patients suspected of tuberculosis who had their gastric aspirate tested for CBNAAT and ZN stain for acid fast bacilli (AFB) along with Mantoux test and other routine investigations. Chi square test was used.Results: Culture positive tuberculosis was found in 21 out of 100 children. The sensitivity, specificity, positive predictive value and negative predictive value for CBNAAT were 76.1%, 98.7%, 94.1% and 93.9% and for ZN stain were 47.6%, 98.7%, 90.9% and 87.6% respectively. Positive history of contact (p value 0.0217), reactive Mantoux test (p value < 0.001) and low socioeconomic status were independently associated with a positive CBNAAT result.Conclusions: Analysis of gastric aspirate samples with CBNAAT is a sensitive and specific method for rapid diagnosis of pulmonary tuberculosis in children who cannot produce sputum. Compared with microscopy, CBNAAT offers better sensitivity and its scale up will improve access to tuberculosis diagnostics in children.

scholarly journals Study on cartridge based nucleic acid amplification test in children with Neurotuberculosis at RNT Medical College, Udaipur, Rajasthan, India

2019 ◽  
Vol 6 (4) ◽  
pp. 1588
Author(s):  
Shashi Bala ◽  
Suresh Goyal
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Nucleic Acid ◽  
Clinical Evaluation ◽  
Controlled Trial ◽  
Nucleic Acid Amplification Test ◽  
Nucleic Acid Amplification ◽  
Gastric Aspirate ◽  
Age Group ◽  
Major Health Problem ◽  
Medical College

Background: The aim was to determine utility of Cartridge based nucleic acid amplification test (CBNAAT) in diagnosis of mycobacterium tuberculosis in children with neurotuberculosis diagnosed on the basis of clinical evaluation, CSF findings and neuroimaging.Methods: A prospective randomized controlled trial was conducted in Pediatric Department of RNT Medical College, Udaipur, Rajasthan, India from July 2017 to June 2018. Total 110 children of age group of 6 months to 18 years with the diagnosis of tubercular meningoencephalitis (TBME) on the basis of clinical evaluation, CSF examination and neuroimaging were included in the study.Results: A total 110 children were enrolled. Maximum number of cases admitted with TBME were among 1-5 years of age group (60.91%). CSF and gastric aspirate were examined by CBNAAT for MTB. 5 (4.55%) children had CBNAAT positivity in CSF. Gastric aspirate was positive among 16 (14.55%) children. None of the patient had CBNAAT positive result both in CSF and gastric aspirate.Conclusions: TBME is a major health problem in children below 5 years. Gene Xpert assay has the potential to significantly improve and escalate the diagnosis of smear-negative body fluid specimens. CBNAAT for mycobacterium tuberculosis was positive in 5 (4.55%) children from CSF and 16 (14.55%) from gastric aspirate. Negative CBNAAT should not prevent any patient with suspected features of TBME from starting anti tubercular treatment (ATT) as sensitivity of this test remains low. Final judgement to start ATT should be based on clinical, biochemical and radiological profile especially in CNS tuberculosis.

Changing Clinicoradiologic Spectrum of Intracranial Neurotuberculosis in Children: A Cross-sectional Study

2020 ◽  
Vol 35 (13) ◽  
pp. 879-888
Author(s):  
Sumiti Banga ◽  
Chandrika Azad ◽  
Rekha Gupta ◽  
Nishit Sawal ◽  
Vidushi Mahajan ◽  
...  
Keyword(s):  
Nucleic Acid ◽  
Care Center ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Nucleic Acid Amplification Test ◽  
Nucleic Acid Amplification ◽  
Gastric Aspirate ◽  
Sectional Study ◽  
Tubercular Meningitis ◽  
Cross Sectional

Background: Neurotuberculosis is among the most severe type of tuberculosis with high mortality and morbidity in all age groups. Various sociodemographic and disease-/treatment-related factors have emerged over the years that can affect clinical and radiologic features of neurotuberculosis. Objective: To investigate various clinical and neuroradiologic presentations of neurotuberculosis. Methodology: This cross-sectional study was done in a tertiary care center of northern India. The patients between the ages of 3 months and 18 years with newly diagnosed neurotuberculosis were enrolled after taking informed consent. Results: A total of 78 patients (37% males) were enrolled. Fifty-six patients (72%) had tubercular meningitis (TBM) and 22 (28%) isolated tuberculomas. Very high percentage of patients in both the groups was BCG vaccinated. In the tubercular meningitis group, fever (68%), headache (59%), and vomiting (54%) were the most common complaints whereas in the tuberculoma group, seizures (95.5%) were the main complaint and systemic symptoms were rare. In tubercular meningitis patients, cerebrospinal fluid–based studies showed cartridge-based nucleic acid amplification test (Xpert MTB/RIF) positivity for Mycobacterium tuberculosis in 17.6% cases, whereas on gastric aspirate and sputum examination, acid-fast bacilli were seen in 30.7% and cartridge-based nucleic acid amplification test was positive in 19% patients. On neuroimaging, hydrocephalus was seen in 44.6% of tubercular meningitis patients, infarcts in 32%, and basal exudates in 12% patients only; coexistent tuberculomas were seen in 53%. Conclusion: Compared with the available literature, the present study showed a smaller percentage of children <5 years of age, stage III tubercular meningitis cases, and typical neuroradiologic findings like hydrocephalus and basal exudates and more tuberculomas associated with tubercular meningitis.

scholarly journals USE OF CARTRIDGE BASED NUCLEIC ACID AMPLIFICATION TEST FOR RAPID DETECTION OF MYCOBACTERIUM TUBERCULOSIS IN PULMONARY AND EXTRAPULMONARY TUBERCULOSIS

2021 ◽  
pp. 29-33
Author(s):  
RASHMI M. KARIGOUDAR ◽  
MAHESH H. KARIGOUDAR ◽  
SANJAY M. WAVARE ◽  
LAKSHMI KAKHANDKI ◽  
SMITHA BAGALI
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Nucleic Acid ◽  
Sensitivity And Specificity ◽  
Extrapulmonary Tuberculosis ◽  
Nucleic Acid Amplification Test ◽  
Nucleic Acid Amplification ◽  
Rifampicin Resistance ◽  
P Value ◽  
Presumptive Diagnosis ◽  
College Hospital

Objective: Tuberculosis is an airborne infection caused by Mycobacterium tuberculosis. Timely diagnosis and treatment are important to prevent the spread of infection. Cartridge-based nucleic acid amplification test (CBNAAT) provides a valuable tool in the early detection of TB. This study is undertaken to evaluate the utility of CBNAAT for the detection of MTB. Comparison of cartridge-based nucleic acid amplification testing with ZN staining. Methods: This prospective observational study was carried out in the Department of Microbiology, BLDEDU’s Shri B. M. Patil Medical College, Hospital and RC and Dr. Karigoudar Diagnostic Laboratory, Vijayapur. A total of 129 samples from patients with the presumptive diagnosis of TB based on history, clinical presentation, and radiological findings were included in the study. All samples were subjected to ZN staining, and Cartridge-based nucleic acid amplification test and data were analyzed. Results: The present study showed ZN smear positivity of 7.75% and CBNAAT positivity of 19.38%. CBNAAT sensitivity and specificity were 90% and 86.55, respectively, compared with ZN staining with a significant P value of <0.001. Conclusion: CBNAAT helps diagnose TB and detect rifampicin resistance within 2-3 h with high sensitivity and specificity. Rifampicin resistance detection is of great concern, which otherwise leads to treatment failure and on time spread of multidrug resistance TB, leading to increased morbidity and mortality.

scholarly journals Cartridge based nucleic acid amplification test negative in highly suspected case of tuberculosis: a case report

2020 ◽  
Vol 8 (3) ◽  
pp. 1130 ◽  
Author(s):  
Kalpesh Moradiya ◽  
Arti Muley ◽  
Sunil Kumar ◽  
Kinjal Patel ◽  
Harshal Mahida
Keyword(s):  
Nucleic Acid ◽  
Pulmonary Tuberculosis ◽  
Diagnostic Yield ◽  
False Negative ◽  
Control Program ◽  
Nucleic Acid Amplification Test ◽  
Nucleic Acid Amplification ◽  
Smear Microscopy ◽  
Suspected Case ◽  
Bacteriological Diagnosis

Diagnosis of pulmonary tuberculosis is challenging till today. Smear microscopy is the easiest, commonest and widely employed tool for confirmatory diagnosis of pulmonary tuberculosis, but it has low sensitivity and specificity. Sputum culture can increase the diagnostic yield by 20-40%, but it takes long duration of 2-8 weeks to give result. The role of newly introduced cartridge based nucleic acid amplification test (CBNAAT) in the revised national TB control program (RNTCP) is highly promising with a higher yield of bacteriological diagnosis in sputum negative pulmonary tuberculosis patients with detection of rifampicin resistance rapidly. However, it also has some limitations which may result in false negative results. Case of a 50- year-old-male was reported who was initially managed for community-acquired pneumonia in view of negative sputum and CBNAAT but was later confirmed to have TB but by then he had developed cavities in lung and had transmitted the infection to his son.

scholarly journals Study of extrapulmonary tuberculosis in tertiary care hospital children with reference to cartridge based nucleic acid amplification test

2021 ◽  
Vol 8 (12) ◽  
pp. 1947
Author(s):  
Chirag Shah ◽  
Shantanu Jain ◽  
Pathik Patel
Keyword(s):  
Nucleic Acid ◽  
Extrapulmonary Tuberculosis ◽  
Tertiary Care ◽  
High Sensitivity ◽  
Tuberculosis Patient ◽  
Nucleic Acid Amplification Test ◽  
Nucleic Acid Amplification ◽  
Care Hospital ◽  
Gastric Aspirate ◽  
Lymph Node Tuberculosis

Background: Tuberculosis is an infectious disease cause by the mycobacterium tuberculosis which typically involve lung but can affect other site called extrapulmonary tuberculosis (EPTB). In EPTB lymph node tuberculosis is most common and most severe is tuberculous meningitis. Cartridge based nucleic acid amplification test (CBNAAT) have high sensitivity and perform both respiratory and non-respiratory specimen. The aim of this retrospective study is to find out the proportion of extra pulmonary tuberculosis in hospitalized patient and determine the association of CBNAAT in diagnosis EPTB and Rifampicin resistance.Methods: This is the retrospective observational study done at Civil Hospital Ahmedabad in between October 2017 to October 2019 among the admitted patient age 1 month to 12 year diagnosed cases of EPTB according to RNTCP guidelines. Data collection done by medical records as indoor case sheets and investigation data from laboratory department.Results: Incidence of EPTB among the hospitalized children is 1.95% and among total tuberculosis patient is 42.48%. Among 191 suspected EPTB cases 59 confirmed indicate sensitivity of 37.3% and no false positive cases indicate 100% positive predictive value. Sensitivity of CBNAAT was highest in gastric aspirate followed by CSF in present study.Conclusions: Tuberculosis is more common in male child less than 5-year-old with frequent risk factor is rural residential area, lower socioeconomic class and contact with active cases. In my study is CNS tuberculosis is most common. In my study mortality is higher among 1-to-5-year age group with co morbid condition are SAM and septicemia.

scholarly journals A Retrospective Cross-Sectional Study of the Utility of Cartridge-Based Nucleic Acid Amplification Test in Diagnosis of Pulmonary and Extrapulmonary Tuberculosis in People Living with HIV in Second Highest HIV Prevalent State in India

2021 ◽  
Author(s):  
Tade Bagbi ◽  
Ningthoukhongjam Reema ◽  
S. Bhagyabati Devi ◽  
Thangjam Gautam Singh ◽  
Mohammad Jaleel ◽  
...  
Keyword(s):  
Nucleic Acid ◽  
Cross Sectional Study ◽  
Nucleic Acid Amplification Test ◽  
Nucleic Acid Amplification ◽  
Rifampicin Resistance ◽  
Sputum Smear ◽  
Smear Microscopy ◽  
Sectional Study ◽  
Cross Sectional ◽  
Smear Negative

Abstract Introduction Tuberculosis (TB) in people living with human immunodeficiency virus (PLHIV) is difficult to diagnose due to fewer organisms in sputum and extrapulmonary samples. Sputum culture takes 4 to 8 weeks for growth of the mycobacteria. Delayed treatment for TB in PLHIV leads to increased mortality. This study evaluated cartridge-based nucleic acid amplification test (CBNAAT) as a diagnostic tool for diagnosis of pulmonary TB (PTB) and extrapulmonary TB (EPTB) in PLHIV in the second most HIV prevalent state in India and for comparing its efficacy between Ziehl–Neelsen (ZN) staining sputum smear–positive and sputum smear–negative TB. Methods This cross-sectional study was conducted in RIMS, Imphal, with 167 PLHIV patients, age 15 years or older, having signs and symptoms of TB. Appropriate samples for sputum microscopy and CBNAAT were sent. Conclusion The overall sensitivity of sputum smear for acid-fast bacillus (AFB) was found to be 30.71% and that of CBNAAT was 38.57%. Sensitivity of CBNAAT for sputum smear–positive and sputum smear–negative TB was 100 and 11.3%, respectively. Sensitivity of ZN smear for AFB of EPTB sample was 48.1% and that of CBNAAT was 59.25%. In both PTB and EPTB, CBNAAT showed an increase in diagnosis of microbiologically confirmed PTB cases by 7.8 and 11.1%, respectively, over and above the cases diagnosed by ZN smear microscopy. Rifampicin resistance was detected in five patients. We conclude that CBNAAT is a rapid test with better sensitivity in diagnosis of PTB and EPTB in PLHIV, compared with ZN smear microscopy. It detects rifampicin resistance for multidrug-resistant TB and helps in early treatment intervention.

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