Shuaib, Yassir A; Khalil, Eltahir AG; Schaible, Ulrich E; Wieler, Lothar H; Bakheit, Mohammed AM; Mohamed-Noor, Saad E; Abdalla, Mohamed A; Homolka, Susanne; Andres, Sönke; Hillemann, Doris; +4 more... Lonnroth, Knut; Richter, Elvira; Niemann, Stefan; Kranzer, Katharina; (2018) Smear Microscopy for Diagnosis of Pulmonary Tuberculosis in Eastern Sudan. Tuberculosis research and treatment, 2018. 8038137-. ISSN 2090-150X DOI: https://doi.org/10.1155/2018/8038137
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Abstract
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.
Item Type | Article |
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Faculty and Department | Faculty of Infectious and Tropical Diseases > Dept of Clinical Research |
Research Centre | TB Centre |
PubMed ID | 30013800 |
Elements ID | 135350 |
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Filename: Smear Microscopy for Diagnosis of Pulmonary Tuberculosis in Eastern Sudan.pdf
Licence: Creative Commons: Attribution 3.0
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