Patterns of Extrapulmonary Tuberculosis Using CBNAAT: A Retrospective Study | Chapter 6 | Medicine and Medical Research: New Perspectives Vol. 11

Background: Extra-pulmonary tuberculosis is a milder form of the disease in terms of infectivity as compared to pulmonary tuberculosis. Diagnosis of Extra-pulmonary TB (EPTB) is a challenge.

Aim: The study seeks to assess the sites of extra-pulmonary involvement during 2013-2017 in a tertiary care hospital cum medical college. The study also wanted to evaluate the role of the Cartridge Based Nucleic Acid Amplification Test (CBNAAT) in the diagnosis of EPTB and compare its efficacy with AFB Culture.

Methods: A total of 470 EPTB cases were diagnosed between 2013 and 2017 from 840 TB treatment records maintained in designated microscopy centre. Specific samples from appropriate sites were taken up for smear for AFB, CBNAAT and AFB culture. The sensitivity and specificity of CB NAAT were also computed. All the analysis was carried out using standard statistically significant STATA 15.1.

Results: There was incremental detection and registration in both TB and EPTB cases from 96 and 50 cases in 2013 to 246 and 150 cases in 2017 respectively. Among the total 470 EPTB cases in 2013-2017 (55.9%), lymph nodes followed by pleura and abdomen were the organs having maximum involvement. Bone involvement was more witnessed in adult males than children (p <0.05). There was male preponderance. CBNAAT results were 100 % sensitive and 87.5% specific. Lymph node samples and pus elsewhere in the body had much better diagnostic yield than serous effusions. The number of patients diagnosed from 2013 revealed a steady increase in numbers till 2017; this is due to improved awareness among the clinicians and availability of new diagnostic modalities in the extrapulmonary presentations and awareness to register in RNTCP services for availing the services.

Conclusions: EPTB needs a high index of suspicion and judicious invasive diagnostic tests. Awareness and availability of diagnostic services in tertiary care institutions have led to increased reporting of EPTB under RNTCP services. CBNAAT can also be utilized as a point of care testing for lymph node aspirate and pus specimens.

 

Author (s) Details

Suman Kumar Jagaty
Department of Respiratory Medicine, Kalinga Institute of Medical Sciences, KIIT (Deemed to be University), Bhubaneswar, India.

 

Swadip Mishra
Department of Respiratory Medicine, Kalinga Institute of Medical Sciences, KIIT (Deemed to be University), Bhubaneswar, India.

 

C. Mohan Rao
Department of Respiratory Medicine, Kalinga Institute of Medical Sciences, KIIT (Deemed to be University), Bhubaneswar, India.

 

Please see the book here:- https://doi.org/10.9734/bpi/mmrnp/v11/2683

Determining the Effectiveness of CBNAAT in the Diagnosis of Extrapulmonary Tuberculosis | Chapter 12 | Advanced Concepts in Medicine and Medical Research Vol. 4

 This affiliate aims to determine the influence and reliability of CBNAAT in the diagnosis of extra pulmonary infection (EPTB) cases in comparison to AFB taint. Tuberculosis is still a major community health issue around the globe. Mycobacterium tuberculosis is thought to pollute one-after second of the world's state. The two types of clinical proof of tuberculosis (TB) are pulmonary TB (PTB) and extrapulmonary TB (EPTB). While pulmonary tuberculosis is most accepted presentation, extrapulmonary infection is also an main clinical question. Diagnosing extrapulmonary tuberculosis continues expected a challenge due to the paucibacillary type of the samples collected from unreachable sites and variable dispassionate presentation of the disease. Various direct and unintended methods of experiment are available for diagnosing extrapulmonary infection accurately. Two of these tests which are usually performed and are surely accessible are AFB taint and CBNAAT. AFB smear test is a system of visualization of acid-fast bacilli under microscope inasmuch as CBNAAT is a cartridge-located nucleic acid elaboration test that has long been used to pinpoint pulmonary tuberculosis (PTB).The study is a retrospective explanatory study conducted at MGM Hospital Aurangabad, Maharashtra, India. The study secondhand data from January 2017 to July 2018. Data from 166 subjects with possible extrapulmonary TB were obtained. The efficacy of CBNAAT in the disease of EPTB was compared to that of AFB besmirch.AFB smear and CBNAAT were acted on samples taken from 166 suspected EPTB inmates. Lymph node, liquid matter, pleural fluid, tissue, CSF, stomachic lavage, cystic fluid, peritoneal fluid, ascitic fluid, colonic fluid, synovial fluid, and excretion samples were collected. In AFB smear results, 17 cases were certain for TB bacilli while 149 proven negative. In the CBNAAT results, 25 cases were positive for TB bacterium whereas 141 proven negative. Eight cases were AFB smear negative but CBNAAT positive in a corresponding examination.The candor and quick reaction time of CBNAAT manage a valuable tool for diagnosing EPTB cases. For the diagnosis of cases accompanying EPTB, CBNAAT is more useful than AFB sully. However, other demonstrative tools concede possibility be taken into consideration in addition to CBNAAT for better diagnostic yield overall.

Author(s) Details:

Shivprasad Kasat,
Department of Respiratory Medicine, MGM Medical College and Hospital, Aurangabad, Maharashtra, India.

Mahendra Biradar,
Department of Respiratory Medicine, MGM Medical College and Hospital, Aurangabad, Maharashtra, India.

Ashish Deshmukh,
Department of Respiratory Medicine, MGM Medical College and Hospital, Aurangabad, Maharashtra, India.

Sunil Jadhav,
Department of Respiratory Medicine, MGM Medical College and Hospital, Aurangabad, Maharashtra, India.

Hafiz Deshmukh,
Department of Respiratory Medicine, MGM Medical College and Hospital, Aurangabad, Maharashtra, India.

Please see the link here: https://stm.bookpi.org/ACMMR-V4/article/view/12481

A Tale of 2 Diseases in Symbiosis: Tuberculosis and COVID-19 | Chapter 06 | Emerging Trends in Disease and Health Research Vol. 6

 COVID-19 is a virus that infects people (COrona VIrus Diagnosed in 2019) There is a symbiotic interaction between and tuberculosis. Their epidemiology, aetiology, and clinical symptoms are all comparable. These two disorders can aggravate and exacerbate each other's symptoms, resulting in a poor prognosis for the patient.

Author(S) Details

Pratap Upadhya
Department of Pulmonary Medicine and Obstetrics/Gynaecology, Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Pondicherry-06, India.

B. Muniza
Department of Pulmonary Medicine and Obstetrics/Gynaecology, Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Pondicherry-06, India.

A. Arpitha
Department of Pulmonary Medicine and Obstetrics/Gynaecology, Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Pondicherry-06, India.


View Book:- https://stm.bookpi.org/ETDHR-V6/article/view/6418

Extrapulmonary Tuberculosis: Is Cartridge Based Nucleic Acid Amplification Test More Superior to the Conventional Methods in Diagnosis? | Chapter 14 | Recent Developments in Medicine and Medical Research Vol. 4

 The lymph nodes, pleura, central nervous system, bones, gastrointestinal tract, and genitourinary tract are the most common sites of extrapulmonary tuberculosis [EPTB]. Isolated lymphadenopathy and effusion in the bodily cavities are the most common symptoms. Fine Needle Aspiration Cytology [FNAC], Acid Fast Bacilli [AFB] demonstration by Zeihl-Neelson [Z-N] stain, and Cartridge Based Nucleic Acid Amplification Test [CBNAAT] are all tests used to detect EPTB. The data of 100 clinically suspected EPTB patients who had undergone FNAC, CBNAAT, and Z-N stain in Mandya Institute of Medical Sciences, Mandya, Karnataka, was used in a retrospective record-based analysis. After receiving approval from the Institutional Ethics Committee, the study was conducted for four months, from March to June 2018. The analysis found 47 situations where FNAC results favoured EPTB. Thirty of the 47 cases tested positive for CBNAAT. Out of 53 instances with negative FNAC results, 5 had positive CBNAAT. Only 13 of the 35 CBNAAT positive individuals tested positive for AFB. To summarise, because of its high specificity and positive predictive value, CBNAAT is a quick, accurate, and simple test for early detection of EPTB. CBNAAT can also detect cases that FNAC and Z-N stain couldn't.

Author(S) Details

M. U. Mythreyi
Mandya Institute of Medical Sciences, Mandya, Karnataka, India.

M. S. Siddegowda
Mandya Institute of Medical Sciences, Mandya, Karnataka, India.

S. Shivakumar
Mandya Institute of Medical Sciences, Mandya, Karnataka, India.

View Book:- https://stm.bookpi.org/RDMMR-V4/article/view/4179