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...
Autores principales: | , , , , , , , , , , , , , |
---|---|
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 |