scholarly journals Prevalence of pulmonary tuberculosis among patients presenting with cough of any duration in Addis Ababa, Ethiopia

2019 ◽  
Author(s):  
Aynye Negesse ◽  
Mulugeta Belay ◽  
Girmay Medhin ◽  
Sosina Ayalew ◽  
Adane Mihret ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Addis Ababa ◽  
Culture Method ◽  
Cross Sectional Study ◽  
Smear Microscopy ◽  
Culture Methods ◽  
Cross Sectional ◽  
Study Participants ◽  
Age Range ◽  
Culture Positive

AbstractBackgroundThe current practice in Ethiopia to diagnose tuberculosis is screening patients with cough for at least two weeks. A health facility based study was conducted to estimate the prevalence of smear and culture positive pulmonary TB among patients presenting with cough ≥2 weeks and <2 weeks in Addis Ababa, Ethiopia.MethodsA cross-sectional study design was used to recruit patients with cough of any duration from four selected health centers in Addis Ababa, between August and December 2016. Sputum samples were collected from patients reporting productive cough of any duration and screened for Pulmonary Tuberculosis (PTB) using smear microscopy and culture methods. Mycobacterium tuberculosis isolates obtained from culture positive samples were characterized using RD9 deletion typing.ResultsMajority (39.7%) of the 725 study participants was in the age range of 20-30 years, and 5.0% were smear positive using smear microscopy. The prevalence of smear positive PTB among patients presented with cough duration of ≥2 weeks was significantly higher compared to those patients presented with cough duration of <2 weeks (10.9% versus 0.7%; χ2=38.98; p=0.001). Using culture method, a total of 86 (11.9%) participants were positive for mycobacteria, and the prevalence (14.6%) of PTB among patients presented with cough duration of ≥2 weeks was not significantly higher compared to prevalence (9.9%) in those patients presented with cough duration of <2 weeks (χ2=3.63; p=0.057). Molecular characterization of 86 culture positive mycobacterial isolates showed that 41 were infected with Mtb; 19(46.3%) from those who had cough duration of <2 weeks and 22(53.7%) from those who had cough duration of ≥2 weeks.ConclusionScreening of PTB using smear microscopy alone and cough duration of at least two weeks would negatively affect early diagnosis and treatment initiation in a considerable number of PTB patients who reports cough duration of <2 weeks with the potential of contributing to the spread of TB. Therefore, screening of patients with cough of any duration using both smear microscopy and culture methods is likely to contribute to the success of any effort towards the control of TB.

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 DETECTION FAILURE OF SMEAR MICROSCOPY TO CONFIRM PULMONARY TUBERCULOSIS

2018 ◽  
Vol 6 (4) ◽  
Author(s):  
Yunusa EU ◽  
Bakare AT ◽  
Shagari GB ◽  
Abubakar AM ◽  
Sharhabila Y ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Positive Culture ◽  
Culture Method ◽  
Molecular Diagnostic ◽  
Smear Microscopy ◽  
Reference Laboratory ◽  
Sample Collection ◽  
Cross Sectional ◽  
Detection Failure ◽  
Culture Positive

Background: The laboratories in poor resource settings commonly use smear microscopy for the diagnosis of pulmonary tuberculosis, because it is rapid, inexpensive and easy to perform. The commonly use Lowensten Jensen culture method for the diagnosis of tuberculosis is slow and usually not very sensitive. Polymerase Chain Reaction (PCR) in the diagnosis of tuberculosis (TB) has come to stay as an effective diagnostic tool for effective pulmonary TB case detections. Objectives: This is to promote and encourage utilization of molecular diagnostic method (PCR) for the diagnosis of tuberculosis especially in smear negative microscopy suspected cases to reduce the rate of missed diagnosis. Material and Methods: This was an observational cross sectional prospective study among patients who presented at tuberculosis reference laboratory with request form for the diagnosis of pulmonary tuberculosis. Consent forms were administered and only consented clients were enrolled in the study. Standard sample collection criteria were used for all collected samples subjected to standard smear microscopy, Lowenstein Jensen culture and PCR studies. Results: Direct smear microscopy (AFB) was positive in 13 (13.5%), 24 (23.3%) were detected by PCR and 20 (19.4%) were culture positive. All positive smears were found to be positive for both culture and PCR. All culture positive samples were positive by PCR, culture growth were also positive by PCR. Most of the PCR results were ready within the first day of the analysis with average of 1.2 days (P = 0.014) of the 103 samples processed. The result of smear microscopy is only ready on the second day after analysis of the second and third samples submitted with reported average of 1.7 days (P = 0.035). The fastest observable growth of positive culture was seen only within ten days and only three cases showed such. It took eight weeks for a negative growth to be regarded as negative. The culture has an average tun around ti

scholarly journals Profiling of potential pulmonary fungal pathogens and the prevalence of the association between pulmonary tuberculosis and potential fungal pathogens in presumptive tuberculosis patients referred to Saint Peter’s Specialized Tuberculosis Referral Hospital, Addis Ababa, Ethiopia

2021 ◽  
Vol 9 ◽  
pp. 205031212110561
Author(s):  
Adane Bitew ◽  
Solomon Bati
Keyword(s):  
Pulmonary Tuberculosis ◽  
Fungal Infection ◽  
Fungal Pathogens ◽  
Addis Ababa ◽  
Age Groups ◽  
Clinical Manifestations ◽  
Brain Heart Infusion ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Study Participants

Objective: The burden of pulmonary fungal infection is increasing and often misdiagnosed as pulmonary tuberculosis in developing countries where the prevalence of pulmonary tuberculosis is high. |Therefore, the purpose of this study is to determine the spectrum of potential pulmonary fungal pathogens and the prevalence of the association between pulmonary tuberculosis and potential fungal pathogens. Materials and methods: A cross-sectional study was conducted between October 2018 and May 2019. Sputum was collected from 636 study participants. Part of the sputum was inoculated onto Brain Heart Infusion agar, and fungi were identified following standard microbiological procedures. The remaining part of the sample was used for the investigation of pulmonary tuberculosis. Results: Among 636 sputum samples, 75.9% (483) and 25.6% (163) were positive for potential fungal pathogens and pulmonary tuberculosis, respectively. The prevalence of the association between pulmonary tuberculosis and potential fungal pathogens was 20.0%. Of fungal isolates, 81.4% were yeasts. The remaining 128 (18.6%) isolates were molds. The isolation rate of fungi was higher in males (51.6%) than in females (48.4%). There was no statistically significant association between the prevalence of potential pulmonary fungal pathogens and sex ( p = 0.239). Patients in the age group of 35 to 44 and above were slightly more affected than younger age groups. The association between potential fungal pathogens and age was not statistically significant ( p = 0.50). Conclusion: High prevalence of potential pulmonary fungal pathogens and the association of tuberculosis and potential fungal pathogens recorded in this study will enforce health personnel to pay due attention to these conditions and arise the interest of researchers to conduct further work on the burden of the association between tuberculosis and potential fungal pathogens. Our study also revealed the need to employ conventional microbiology tests along with clinical and radiological evidence since clinical manifestations and radiological pictures of tuberculosis mimic that of pulmonary fungal infection.

scholarly journals DETECTION FAILURE OF SMEAR MICROSCOPY TO CONFIRM PULMONARY TUBERCULOSIS

2018 ◽  
Vol 6 (4) ◽  
Author(s):  
Yunusa EU ◽  
Bakare AT ◽  
Shagari GB ◽  
Abubakar AM ◽  
Sharhabila Y ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Positive Culture ◽  
Culture Method ◽  
Molecular Diagnostic ◽  
Smear Microscopy ◽  
Reference Laboratory ◽  
Sample Collection ◽  
Cross Sectional ◽  
Detection Failure ◽  
Culture Positive

Background: The laboratories in poor resource settings commonly use smear microscopy for the diagnosis of pulmonary tuberculosis, because it is rapid, inexpensive and easy to perform. The commonly use Lowensten Jensen culture method for the diagnosis of tuberculosis is slow and usually not very sensitive. Polymerase Chain Reaction (PCR) in the diagnosis of tuberculosis (TB) has come to stay as an effective diagnostic tool for effective pulmonary TB case detections. Objectives: This is to promote and encourage utilization of molecular diagnostic method (PCR) for the diagnosis of tuberculosis especially in smear negative microscopy suspected cases to reduce the rate of missed diagnosis. Material and Methods: This was an observational cross sectional prospective study among patients who presented at tuberculosis reference laboratory with request form for the diagnosis of pulmonary tuberculosis. Consent forms were administered and only consented clients were enrolled in the study. Standard sample collection criteria were used for all collected samples subjected to standard smear microscopy, Lowenstein Jensen culture and PCR studies. Results: Direct smear microscopy (AFB) was positive in 13 (13.5%), 24 (23.3%) were detected by PCR and 20 (19.4%) were culture positive. All positive smears were found to be positive for both culture and PCR. All culture positive samples were positive by PCR, culture growth were also positive by PCR. Most of the PCR results were ready within the first day of the analysis with average of 1.2 days (P = 0.014) of the 103 samples processed. The result of smear microscopy is only ready on the second day after analysis of the second and third samples submitted with reported average of 1.7 days (P = 0.035). The fastest observable growth of positive culture was seen only within ten days and only three cases showed such. It took eight weeks for a negative growth to be regarded as negative. The culture has an average tun around ti

scholarly journals Evaluation of the performance of clinical predictors in estimating the probability of pulmonary tuberculosis among smear-negative cases in Northern Ethiopia: a cross-sectional study

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e037913
Author(s):  
Mala George ◽  
Geert-Jan Dinant ◽  
Efrem Kentiba ◽  
Teklu Teshome ◽  
Abinet Teshome ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Cross Sectional Study ◽  
Clinical Suspicion ◽  
Secondary Outcome ◽  
Northern Ethiopia ◽  
Sectional Study ◽  
Cross Sectional ◽  
Smear Negative ◽  
Culture Positive ◽  
Culture Negative

ObjectivesTo evaluate the performance of the predictors in estimating the probability of pulmonary tuberculosis (PTB) when all versus only significant variables are combined into a decision model (1) among all clinical suspects and (2) among smear-negative cases based on the results of culture tests.DesignA cross-sectional study.SettingTwo public referral hospitals in Tigray, Ethiopia.ParticipantsA total of 426 consecutive adult patients admitted to the hospitals with clinical suspicion of PTB were screened by sputum smear microscopy and chest radiograph (chest X-ray (CXR)) in accordance with the Ethiopian guidelines of the National Tuberculosis and Leprosy Program. Discontinuation of antituberculosis therapy in the past 3 months, unproductive cough, HIV positivity and unwillingness to give written informed consent were the basis of exclusion from the study.Primary and secondary outcome measuresA total of 354 patients were included in the final analysis, while 72 patients were excluded because culture tests were not done.ResultsThe strongest predictive variables of culture-positive PTB among patients with clinical suspicion were a positive smear test (OR 172; 95% CI 23.23 to 1273.54) and having CXR lesions compatible with PTB (OR 10.401; 95% CI 5.862 to 18.454). The regression model had a good predictive performance for identifying culture-positive PTB among patients with clinical suspicion (area under the curve (AUC) 0.84), but it was rather poor in patients with a negative smear result (AUC 0.64). Combining all the predictors in the model compared with only the independent significant variables did not really improve its performance to identify culture-positive (AUC 0.84–0.87) and culture-negative (AUC 0.64–0.69) PTB.ConclusionsOur finding suggests that predictive models based on clinical variables will not be useful to discriminate patients with culture-negative PTB from patients with culture-positive PTB among patients with smear-negative cases.

scholarly journals Comparison of Led Fluorescent Microscopy and the Gene Xpert MTB/RIF Assay in Diagnosis of Pulmonary and Extrapulmonary Tuberculosis

2019 ◽  
Vol 6 ◽  
pp. 127-132
Author(s):  
Sanam Thapa Magar ◽  
Gokarna Ghimire ◽  
Pradeep Kumar Shah
Keyword(s):  
Pulmonary Tuberculosis ◽  
Extrapulmonary Tuberculosis ◽  
Fluorescent Microscopy ◽  
Cross Sectional Study ◽  
Smear Microscopy ◽  
Cross Sectional ◽  
Female Ratio ◽  
Standard Guideline ◽  
National Tuberculosis ◽  
Male To Female

Objectives: The objective of this study was to evaluate Gene Xpert MTB/RIF Assay and anid fast staining (AFB) for rapid detection of Mycobacterium tuberculosis in specimen of patients suspected of pulmonary tuberculosis (PTB) and extra pulmonary tuberculosis (EPTB). Methods: A comparative cross-sectional study of 400 samples (PTB-365 and EPTB-35) of patients visiting National Tuberculosis Centre (NTC) was conducted from July 2018 to December 2018. Gene Xpert MTB/ RIF Assay, smear microscopy were performed under standard guideline inside biosafety cabinet class II. The result obtained from both the tests were analyzed using SPSS 20.0 software and Excel 2019. Results: Of the total samples, 18% (72/400) and 39% (156/400) were positive by AFB smear microscopy and Xpert MTB/RIF assay respectively. Prevalence of MTB positive was highest in the age group 35-44 years, 33 cases (17.74%) were detected in total, with a male to female ratio of 2.3:1. Pleural fluid, pus, and CSF fluid also yielded positive results with the Gene Xpert MTB/RIF assay accounting 1.28%, 0.64% and 1.28% of MTB positive case respectively. Rifampicin resistance was observed in 1.28% of the cases. Conclusion: The key findings of this study suggest that Gene Xpert test should be implemented as primary diagnostic test for PTB and EPTB.

scholarly journals Evaluation of a manual identification system for detection of Mycobacterium tuberculosis in a primary tuberculosis laboratory in China

2019 ◽  
Vol 47 (6) ◽  
pp. 2666-2673 ◽  
Author(s):  
Ping Zhao ◽  
Qin Yu ◽  
Yu Zhang
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Diagnostic Performance ◽  
Culture Method ◽  
Cross Sectional Study ◽  
Identification System ◽  
Culture Methods ◽  
Cross Sectional ◽  
Indicator Tube ◽  
Conventional Culture ◽  
Time To Detection

Objective To compare the diagnostic performance of the manual BACTEC™ Mycobacteria Growth Indicator Tube (MGIT™) system (M-MGIT) with the automated BACTEC™ MGIT™ 960 system (A-MGIT) and Löwenstein-Jensen (L-J) culture method in detecting mycobacteria in sputum specimens from patients with suspected pulmonary tuberculosis (TB). Methods For this cross-sectional study, sputum samples were taken from patients aged ≥18 years attending a TB clinic in Beijing, China between July 2015 and October 2016. Processed sputum samples were inoculated into the MGIT systems and L-J medium for up to 6 and 8 weeks, respectively. Results The M-MGIT and A-MGIT methods detected significantly more Mycobacterium tuberculosis complex (MTC) isolates than L-J culture from the 565 sputum samples (39%, 40% and 32%, respectively). Using a positive result from any of the three culture systems as reference, the sensitivity of M-MGIT, A-MGIT and L-J methods were 92%, 94%, and 74%, respectively. The time-to-detection of mycobacteria was 12.9±4.2 days for M-MGIT, 11.8±5.2 days for A-MGIT and 24.2±8.7 days for L-J. Conclusions M-MGIT has a similar diagnostic performance to A-MGIT, and is a fast and reliable alternative to conventional culture methods in the diagnosis of pulmonary TB in a developing country.

scholarly journals Prevalence of Pulmonary Tuberculosis Among HIV Infected Drug Users in Pokhara, Kaski, Nepal

1970 ◽  
Vol 7 (2) ◽  
pp. 19-25
Author(s):  
SC Verma ◽  
GP Dhungana ◽  
HS Joshi ◽  
HB Kunwar ◽  
RK Jha ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Drug Users ◽  
Clinical Symptoms ◽  
Cross Sectional Study ◽  
Hiv Care ◽  
Cross Sectional ◽  
Behavioral Attributes ◽  
Study Participants ◽  
Major Drug ◽  
Hiv Aids

Introduction: Studies conducted in different countries suggest that HIV infected drug users have a higher chance of acquiring pulmonary tuberculosis (PTB) in comparison to general population. However, there is no information about the prevalence of PTB among HIV infected drug users in Nepal. Objectives: The main objectives of this study were to document the socio-demographic and behavioral attributes; clinical symptoms and prevalence of PTB in HIV infected drug users in Pokhara, Kaski, Nepal. Methods: In a cross-sectional study, we enrolled 62 HIV infected drug users not diagnosed with PTB in the past from five HIV care centers in Pokhara. Using questionnaire, first we documented participants’ socio-demographic and behavioral attributes and clinical symptoms. This was followed by tuberculosis testing in all enrolled participants at the Regional Tuberculosis Center (RTC) in Pokhara. Results: Of the 62 HIV infected drug users, PTB was diagnosed in 3 (4.8%) participants. All of them were male in the productive age group. Cough was the major clinical symptoms (54.8%) in the study participants. About 91.9% participants reported they had acquired HIV infection through injecting drug use. Buprenorphine/heroin was the major drug used (48.4%) for addiction. Conclusion: This study provides first evidence of prevalence of PTB in HIV infected drug users in Nepal. The findings suggest tuberculosis testing be conducted in HIV infected persons including the HIV infected drug users in Nepal. Early detection of PTB in HIV infected drug users may help to reduce the morbidity and mortality as well as spread of TB in the community. Keywords: Drug users; HIV/AIDS; Nepal; Pokhara; TuberculosisDOI: 10.3126/saarctb.v7i2.4401SAARC J. TUBER. LUNG DIS. HIV/AIDS 2010 VII(2) 19-25

scholarly journals Prevalence and Drug Resistance Patterns ofMycobacterium tuberculosisamong New Smear Positive Pulmonary Tuberculosis Patients in Eastern Ethiopia

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Berhanu Seyoum ◽  
Meaza Demissie ◽  
Alemayehu Worku ◽  
Shiferaw Bekele ◽  
Abraham Aseffa
Keyword(s):  
Drug Resistance ◽  
Pulmonary Tuberculosis ◽  
Addis Ababa ◽  
Cross Sectional Study ◽  
Close Monitoring ◽  
Cross Sectional ◽  
Eastern Ethiopia ◽  
Tuberculosis Patients ◽  
Smear Positive Pulmonary Tuberculosis ◽  
Resistance Patterns

The study aimed at determining the prevalence and drug resistance patterns ofMycobacterium tuberculosisamong new smear positive pulmonary tuberculosis patients visiting TB diagnosis and treatment facilities at selected health facilities in eastern Ethiopia. A cross-sectional study was conducted between October 2011 and May 2013. A total of 408 new adult pulmonary TB patients (≥ 18 years) were enrolled in this study. Three consecutive sputum samples (spot, morning, and spot) were collected from each patient and transported to the Armauer Hansen Research Institute TB laboratory located in Addis Ababa for culture on Lowenstein Jensen slant media. DST was performed on 357 (87.5%) of the patient samples for isoniazid (H), rifampicin (R), ethambutol (E), and streptomycin (S) using the standard proportion method. The rate of resistance to any one drug was 23%. Any resistance to H, S, R, and E was 14%, 11.5%, 2.8%, and 0.3%, respectively. The highest proportion of monoresistance was observed against H (9.5%). MDRTB was detected in 1.1% of the patients. Any drug resistance was associated with HIV infection (COR = 3.7, 95% CI 1.905–7.222) (P= 0.000). Although the prevalence of MDRTB is relatively low in the study area, high prevalence of H resistance is a serious concern demanding close monitoring. Expanding diagnostic capacity for mycobacterial culture and DST is a vital step in this regard.

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