A Prospective Comparative Study of Diagnostic Accuracy between TrueNat and GeneXpert for the Diagnosis of Pulmonary Tuberculosis |Chapter 6 | Medical Science: Updates and Prospects Vol. 3

 

Background: Tuberculosis (TB) is a chronic infectious disease caused by Mycobacterium tuberculosis (MTB), primarily transmitted via airborne particles. The currently recommended methods for diagnosing tuberculosis (TB) include molecular-based tests that can detect both TB and drug-resistant forms of the disease. Enhancing access to reliable and accurate diagnosis of tuberculosis (TB) is a priority for global TB control. Molbio Diagnostics has developed the TrueNat point-of-care molecular assays for detecting TB and rifampicin (RIF) resistance. Until 2020, the Xpert system was the only WHO-recommended option for rapid molecular detection of both TB and rifampin-resistant TB. This study aimed to compare the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of GeneXpert with TrueNat, using the MGIT test as the gold standard.

 

Methods: A cross-sectional comparative study involved 350 patients with suspected pulmonary TB at the Intermediate Reference Laboratory in the Government Hospital for Chest Diseases, Puducherry, India. Sputum samples were collected in pre-sterilised tubes, transported at 2–8°C to the reference laboratory, and processed using the NALC-NaOH method, with aliquots allocated for microscopy, culture, TrueNat, and Xpert testing, while excess was stored at –80°C. The BACTEC-MGIT-960 test is used to detect the growth of M. tuberculosis in drug-containing and drug-free tubes. The sensitivity, specificity, PPV, NPV, and diagnostic accuracy for tuberculosis diagnosis were calculated for TrueNat and GeneXpert and compared to the MGIT results. Data analysis was performed using MedCalc Software Ltd., specifically the Odds Ratio Calculator (Version 23.1.6).

 

Results: Among the 350 patients, 296 (84.57%) tested positive for TB with GeneXpert, while 280 (80.00%) tested positive with TrueNat. For the GeneXpert assay in detecting pulmonary TB in sputum samples, the sensitivity was 98.66%, the specificity was 96.15%, the PPV was 99.32%, the NPV was 92.59%, and the accuracy was 98.29%. In comparison, the TrueNat technique had a sensitivity of 93.22%, specificity of 90.91%, PPV of 98.21%, NPV of 71.43%, and accuracy of 92.86%. The agreement between the TrueNat assay and the GeneXpert method, using the BACTEC-MGIT-960 method for detecting Mycobacterium tuberculosis in pulmonary samples, was significant, with Kappa values of 0.76 (S.E.: 0.05) for TrueNat and 0.93 (S.E.: 0.03) for GeneXpert.

 

Conclusion: Overall, the GeneXpert assay demonstrated greater sensitivity than TrueNat in respiratory samples. It is advisable to interpret TrueNat negative results cautiously and to correlate them closely with the patient's clinical and treatment history.

 

 

Author(s) Details

Balasundaram Revathi Mani
Department of Biochemistry, Queen Mary’s College, Madras, Tamil Nadu, India.

 

Usharani Brammacharry
Institute of Basic Medical Sciences, University of Madras, Chennai, Tamil Nadu, India.

 

Venkateswari Ramachandra
Institute of Basic Medical Sciences, University of Madras, Chennai, Tamil Nadu, India.

 

Muthuraj Muthaiah
Department of Microbiology, State TB Training and Demonstration Centre, Intermediate Reference Laboratory, Government Hospital for Chest Diseases, Puducherry, India.

 

Please see the book here :- https://doi.org/10.9734/bpi/msup/v3/6786

Application of Florence Nightingale’s Environmental Theory to Pulmonary TB in Fishermen and Smoked Fish Industry Workers | Chapter 3 | An Overview of Disease and Health Research Vol. 2

Introduction: The process of smoking fish in Indonesia is still carried out traditionally and can affect the fishermen and smoked fish industry communities who have pulmonary Tuberculosis (TB). The environmental impact that commonly occurs as a result of smoked fish processing activities is air pollution due to the smoke that arises. Florence Nightingale, often celebrated as the icon of modern nursing, proposes a theory emphasising the critical role of the environment in health and recovery. She believes that a healthy environment is necessary for proper treatment and maintenance of health.

Aim: This study aims to apply the Florence Nightingale Theory in cases of pulmonary TB among fishermen and the smoked fish industry communities.

Materials and Methods: This investigation was conducted in the Somba area, West Sulawesi, which is one of the areas with the most smoked fish industry in West Sulawesi. This study used an analytic observational method with a case-control design. This study used non-probability sampling and purposive sampling techniques with the sample. The number of respondents was 106, consisting of 53 respondents in the case group and 53 respondents in the control group. The data obtained were then analysed using Chi-Square.

Results: Findings reveal that the environment exposed to smoke from smoking fish, smoking habit, and window opening habit have an influence on the incidence of pulmonary TB. This follows the emphasis of Nightingale's environmental theory, stating that pure air and lighting are included in the main components influencing the environment. The environment exposed to smoke from smoking fish has a p-value of 0.001 with OR 3.718, smoking habit has a p-value of 0.034 with OR 2.842, and window opening habit has a p- p-value of 0.000 with OR 0.391. Whereas, occupancy density and cooking fuel have no influence on the incidence of pulmonary TB, as evidenced by statistical tests with a p-value of >0.005.

Conclusion: The incidence of pulmonary TB in fishermen and smoked fish industry communities is influenced by the environment exposed to smoke from smoking fish and the window opening habit. This follows the emphasis of Nightingale's environmental theory, stating that pure air and lighting are included in the main components influencing the environment.

 

 

Author (s) Details

Darwis Darwis
Department of Nursing, Sekolah Tinggi Ilmu Kesehatan Nani Hasanuddin, Makassar-90245, Indonesia.

 

Muzakkir
Department of Nursing, Sekolah Tinggi Ilmu Kesehatan Nani Hasanuddin, Makassar-90245, Indonesia.

 

Erviana
Department of Nursing, Faculty of Health Science, Universitas Sulawesi Barat, Majene-91412, Indonesia.

 

Ika Muzdalia
Department of Nursing, Faculty of Health Science, Universitas Sulawesi Barat, Majene-91412, Indonesia.

 

Rizky Maharja
Faculty of Health Science, Universitas Sulawesi Barat, Majene-91412, Indonesia.

 

 

Please see the book here:- https://doi.org/10.9734/bpi/aodhr/v2/5497

Spectrum of Tuberculosis: A Study among Adolescent in a Tertiary Care Hospital at Shimla, North India | Chapter 11 | Novel Research Aspects in Medicine and Medical Science Vol. 9

 The study's aim is to examine the range of juveniles tuberculosis. Adolescence is characterised by a solid increase in the incidence of tuberculosis, a famous fact because the early 20th century. Most of the world's minors live in low-wage and middle-income nations where tuberculosis remnants common, and place they comprise a quarter of the population. Despite this, youths have not yet happened addressed as additional population in tuberculosis procedure or within infection treatment services, and arising evidence suggests that current models of care do not meet their needs. Tuberculosis amongst youngsters is distinct from two together childhood and adult tuberculosis in agreements of incidence, ailment manifestations and response. These characteristics are due to issues related to exemption, hormone inequality, social interactions and medicine unique to this chapter of life. Adolescent tuberculosis debris a less studied area in India. We resolved demographic, dispassionate and paraclinical data from 477 adolescents (10-19 age of age) determined to have Tuberculosis, who reported to the in the Department of paediatrics, Indira Gandhi Medical College, Shimla middle from two points the years 2010 and 2014. The incidence of infection among emergency room visiting adolescents was 0.8%. The incidence in women (1.00 %) was significantly more distinguished to males (0.63 %) with women having (OR1.60) 1.60 times more probability of suffering from Tuberculosis than men (p< 0.001). Isolated Pulmonary tuberculosis (PTB) was seen in 52% cases, extrapulmonary infection (EPTB) in 40 % and combined PTB accompanying EPTB in 8 % cases. The most common forms of extrapulmonary tuberculosis were pleural outpouring (25.6%) and central nervous system infection (24.7%). Infiltration (consolidation) was ultimate common chest radioactivity finding (53.7 %). Most instances of infection were caused by pulmonary illness. The most frequent extrapulmonary types were private pleural effusion, tuberculosis of the main nervous system, and intestinal TB, whereas lymphadenitis was less frequent. In compared to brothers, females had a significantly higher incidence (P<0.001).

Author(s) Details:

Shayam L. Kaushik,
Department of Paediatrics, Indira Gandhi Medical College, Shimla, India.

Savita Krishnamurthy,
Department of Paediatrics, Indira Gandhi Medical College, Shimla, India.

Neelam Grover,
Department of Paediatrics, Indira Gandhi Medical College, Shimla, India.

Rajni Kaushik,
Department of Pathology, Indira Gandhi Medical College, Shimla, India.

Please see the link here: https://stm.bookpi.org/NRAMMS-V9/article/view/12259

The Stand of Induced Sputum and Bronchoscopy in the Diagnosis of Sputum Smear-negative Pulmonary Tuberculosis: A Recent Study | Chapter 3 | New Advances in Medicine and Medical Science Vol. 7

 The discovery of acid-fast bacilli (AFB) in spit samples is essential for pulmonary tuberculosis disease.  Sputum production concede possibility be absent in 40-60% of cases with probable pulmonary infection. Identification of active pulmonary infection disease inmates is an important component of TB control as early appropriate situation renders these inmates non-Infectious and interrupts the chain of transmission of TB. We transported a prospective study to check the outcome of maddened sputum and bronchoscopy in inmates with spit Smear negative pulmonary tuberculosis and clinical and radiological traits suggestive of alive pulmonary tuberculosis.To equate the functions of induced spit and bronchoscopy, acid-fast bacilli were manifested in all victims during bronchial washing, bronchial brushing, and post-bronchoscopy spit.  Additionally, it was noted that the group's average age was 44.61 ± 16.77 age. It was noted that 29 cases (63.0% of them fellows) and 17 patients (37.0% of them girls) were present. AFB was detected in inferred sputum in 14 (30.4%) of the cases and in 32 (69.6%), respectively. 21 (45.7%) cases had helpful bronchial washes for AFB, while 25 (54.3%) cases had negative washes. In 23 (50%) cases, bronchial brushing for AFB was positive, and skilled were an equal number of negative cases. Our investigation proved that, in individuals accompanying pulmonary tuberculosis whose saliva smears are negative, bronchoscopy is crucial in the disease. In patients accompanying significant clinical and radiological clues of pulmonary tuberculosis and those accompanying more risk factors, bronchoscopy shows a bigger bacteriological confirmation for infection diagnosis.

Author(s) Details:

Vikash Gupta,
SRMS, Pulmonary Medicine, Bareilly, Uttar Pradesh, India.

Rajeev Tandon,
SRMS, Pulmonary Medicine, Bareilly, Uttar Pradesh, India.

Vijeta Niranjan,
Department of Clinical Hematology, King George’s Medical University, Lucknow, U.P.-226003, India.

Ankit Kumar,
Department of Respiratory Medicine, King George’s Medical University, Lucknow, U.P.-226003, India.

Please see the link here: https://stm.bookpi.org/NAMMS-V7/article/view/11033

Validity and Reliability of Indonesian Languages Version of Zung Self-Rating Depression Scale Questionnaire for Pulmonary Tuberculosis Patients: A Recent Update | Chapter 6 | Current Topics in Medicine and Medical Research Vol. 13

 Patients with chronic diseases, such as tuberculosis, can quickly become depressed. To detect depression in Tuberculosis patients, a valid and reliable instrument is needed. Since so many Indonesians are unable to read the English edition, the Indonesian language version of the Zung Self-Rating Depression Scale questionnaire must be proven as a credible and accurate instrument.

The aim of this study is to find out whether the Indonesian language version of the Zung Self-Rating Depression Scale questionnaire is accurate and reliable.

Methods: A cross-sectional study was conducted in which pulmonary tuberculosis patients were given the Zung Self-Rating Depression Scale questionnaire, which had been translated into Indonesian. The population's characteristics were presented as mean, standard deviation, and percentage. For the validity test, a Corrected Item-Total Correlation table was used, and the reliability test result was presented as a Cronbach's Alpha value.

The population in this study has an average age of 47.75 8.44 years. The majority of them have married (93 percent ). 69 percent of male and female pulmonary tuberculosis patients have only completed elementary school, while 33% have only completed high school. Since the Corrected Item-Total Correlation values for all 20 questions are greater than r table (>0,195), they are all true. The questionnaire is also accurate, with a r Alpha value of 0.887, which is higher than the r table value (>0,195).

Conclusion: The Zung Self-Rating Depression Scale questionnaire in Indonesian is a true and accurate tool for detecting depression in adult pulmonary tuberculosis patients.

Author (s) Details

Tirta Darmawan Susanto
Faculty of Medicine, Universitas Pelita Harapan, Tangerang, Banten, Indonesia

Bambang Sutrisna
Faculty of Public Health, Universitas Indonesia, Depok, West Java, Indonesia

Asri C. Adisasmita
Faculty of Public Health, Universitas Indonesia, Depok, West Java, Indonesia

Annabella Vinsensa
Faculty of Medicine, Universitas Pelita Harapan, Tangerang, Banten, Indonesia

S. N. Mega Tri Anggraini
Faculty of Nursing, Universitas Pelita Harapan, Tangerang, Banten, Indonesia

View Book :- https://stm.bookpi.org/CTMMR-V13/article/view/737