Cargando…

Smear Microscopy for Diagnosis of Pulmonary Tuberculosis in Eastern Sudan

BACKGROUND: In Sudan, tuberculosis diagnosis largely relies on clinical symptoms and smear microscopy as in many other low- and middle-income countries. The aim of this study was to investigate the positive predictive value of a positive sputum smear in patients investigated for pulmonary tuberculos...

Descripción completa

Detalles Bibliográficos
Autores principales: Shuaib, Yassir A., Khalil, Eltahir A. G., Schaible, Ulrich E., Wieler, Lothar H., Bakheit, Mohammed A. M., Mohamed-Noor, Saad E., Abdalla, Mohamed A., Homolka, Susanne, Andres, Sönke, Hillemann, Doris, Lonnroth, Knut, Richter, Elvira, Niemann, Stefan, Kranzer, Katharina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6022320/
https://www.ncbi.nlm.nih.gov/pubmed/30013800
http://dx.doi.org/10.1155/2018/8038137
_version_ 1783335654308970496
author Shuaib, Yassir A.
Khalil, Eltahir A. G.
Schaible, Ulrich E.
Wieler, Lothar H.
Bakheit, Mohammed A. M.
Mohamed-Noor, Saad E.
Abdalla, Mohamed A.
Homolka, Susanne
Andres, Sönke
Hillemann, Doris
Lonnroth, Knut
Richter, Elvira
Niemann, Stefan
Kranzer, Katharina
author_facet Shuaib, Yassir A.
Khalil, Eltahir A. G.
Schaible, Ulrich E.
Wieler, Lothar H.
Bakheit, Mohammed A. M.
Mohamed-Noor, Saad E.
Abdalla, Mohamed A.
Homolka, Susanne
Andres, Sönke
Hillemann, Doris
Lonnroth, Knut
Richter, Elvira
Niemann, Stefan
Kranzer, Katharina
author_sort Shuaib, Yassir A.
collection PubMed
description BACKGROUND: In Sudan, tuberculosis diagnosis largely relies on clinical symptoms and smear microscopy as in many other low- and middle-income countries. The aim of this study was to investigate the positive predictive value of a positive sputum smear in patients investigated for pulmonary tuberculosis in Eastern Sudan. METHODS: Two sputum samples from patients presenting with symptoms suggestive of tuberculosis were investigated using direct Ziehl-Neelsen (ZN) staining and light microscopy between June to October 2014 and January to July 2016. If one of the samples was smear positive, both samples were pooled, stored at −20°C, and sent to the National Reference Laboratory (NRL), Germany. Following decontamination, samples underwent repeat microscopy and culture. Culture negative/contaminated samples were investigated using polymerase chain reaction (PCR). RESULTS: A total of 383 samples were investigated. Repeat microscopy categorized 123 (32.1%) as negative, among which 31 were culture positive. This increased to 80 when PCR and culture results were considered together. A total of 196 samples were culture positive, of which 171 (87.3%), 14 (7.1%), and 11 (5.6%) were M. tuberculosis, M. intracellulare, and mixed species. Overall, 15.6% (57/365) of the samples had no evidence of M. tuberculosis, resulting in a positive predictive value of 84.4%. CONCLUSIONS: There was a discordance between the results of smear microscopy performed at local laboratories in the Sudan and at the NRL, Germany; besides, a considerable number of samples had no evidence of M. tuberculosis. Improved quality control for smear microscopy and more specific diagnostics are crucial to avoid possible overtreatment.
format Online
Article
Text
id pubmed-6022320
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher Hindawi
record_format MEDLINE/PubMed
spelling pubmed-60223202018-07-16 Smear Microscopy for Diagnosis of Pulmonary Tuberculosis in Eastern Sudan Shuaib, Yassir A. Khalil, Eltahir A. G. Schaible, Ulrich E. Wieler, Lothar H. Bakheit, Mohammed A. M. Mohamed-Noor, Saad E. Abdalla, Mohamed A. Homolka, Susanne Andres, Sönke Hillemann, Doris Lonnroth, Knut Richter, Elvira Niemann, Stefan Kranzer, Katharina Tuberc Res Treat Research Article BACKGROUND: In Sudan, tuberculosis diagnosis largely relies on clinical symptoms and smear microscopy as in many other low- and middle-income countries. The aim of this study was to investigate the positive predictive value of a positive sputum smear in patients investigated for pulmonary tuberculosis in Eastern Sudan. METHODS: Two sputum samples from patients presenting with symptoms suggestive of tuberculosis were investigated using direct Ziehl-Neelsen (ZN) staining and light microscopy between June to October 2014 and January to July 2016. If one of the samples was smear positive, both samples were pooled, stored at −20°C, and sent to the National Reference Laboratory (NRL), Germany. Following decontamination, samples underwent repeat microscopy and culture. Culture negative/contaminated samples were investigated using polymerase chain reaction (PCR). RESULTS: A total of 383 samples were investigated. Repeat microscopy categorized 123 (32.1%) as negative, among which 31 were culture positive. This increased to 80 when PCR and culture results were considered together. A total of 196 samples were culture positive, of which 171 (87.3%), 14 (7.1%), and 11 (5.6%) were M. tuberculosis, M. intracellulare, and mixed species. Overall, 15.6% (57/365) of the samples had no evidence of M. tuberculosis, resulting in a positive predictive value of 84.4%. CONCLUSIONS: There was a discordance between the results of smear microscopy performed at local laboratories in the Sudan and at the NRL, Germany; besides, a considerable number of samples had no evidence of M. tuberculosis. Improved quality control for smear microscopy and more specific diagnostics are crucial to avoid possible overtreatment. Hindawi 2018-06-14 /pmc/articles/PMC6022320/ /pubmed/30013800 http://dx.doi.org/10.1155/2018/8038137 Text en Copyright © 2018 Yassir A. Shuaib et al. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Shuaib, Yassir A.
Khalil, Eltahir A. G.
Schaible, Ulrich E.
Wieler, Lothar H.
Bakheit, Mohammed A. M.
Mohamed-Noor, Saad E.
Abdalla, Mohamed A.
Homolka, Susanne
Andres, Sönke
Hillemann, Doris
Lonnroth, Knut
Richter, Elvira
Niemann, Stefan
Kranzer, Katharina
Smear Microscopy for Diagnosis of Pulmonary Tuberculosis in Eastern Sudan
title Smear Microscopy for Diagnosis of Pulmonary Tuberculosis in Eastern Sudan
title_full Smear Microscopy for Diagnosis of Pulmonary Tuberculosis in Eastern Sudan
title_fullStr Smear Microscopy for Diagnosis of Pulmonary Tuberculosis in Eastern Sudan
title_full_unstemmed Smear Microscopy for Diagnosis of Pulmonary Tuberculosis in Eastern Sudan
title_short Smear Microscopy for Diagnosis of Pulmonary Tuberculosis in Eastern Sudan
title_sort smear microscopy for diagnosis of pulmonary tuberculosis in eastern sudan
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6022320/
https://www.ncbi.nlm.nih.gov/pubmed/30013800
http://dx.doi.org/10.1155/2018/8038137
work_keys_str_mv AT shuaibyassira smearmicroscopyfordiagnosisofpulmonarytuberculosisineasternsudan
AT khalileltahirag smearmicroscopyfordiagnosisofpulmonarytuberculosisineasternsudan
AT schaibleulriche smearmicroscopyfordiagnosisofpulmonarytuberculosisineasternsudan
AT wielerlotharh smearmicroscopyfordiagnosisofpulmonarytuberculosisineasternsudan
AT bakheitmohammedam smearmicroscopyfordiagnosisofpulmonarytuberculosisineasternsudan
AT mohamednoorsaade smearmicroscopyfordiagnosisofpulmonarytuberculosisineasternsudan
AT abdallamohameda smearmicroscopyfordiagnosisofpulmonarytuberculosisineasternsudan
AT homolkasusanne smearmicroscopyfordiagnosisofpulmonarytuberculosisineasternsudan
AT andressonke smearmicroscopyfordiagnosisofpulmonarytuberculosisineasternsudan
AT hillemanndoris smearmicroscopyfordiagnosisofpulmonarytuberculosisineasternsudan
AT lonnrothknut smearmicroscopyfordiagnosisofpulmonarytuberculosisineasternsudan
AT richterelvira smearmicroscopyfordiagnosisofpulmonarytuberculosisineasternsudan
AT niemannstefan smearmicroscopyfordiagnosisofpulmonarytuberculosisineasternsudan
AT kranzerkatharina smearmicroscopyfordiagnosisofpulmonarytuberculosisineasternsudan