Roleof Cartridge-Based Nucleic Acid Amplification Test (Cbnaat) For Early Diagnosis of Tuberculosis: A Retrospective Study
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2018, Vol 17, Issue 11
Abstract
Background: About one fifth of global Tuberculosis (TB) burden present in INDIA and it is ninth leading cause of death worldwide. It is very important to early diagnose and treat Tuberculosis cases to stop transmission. Smear microscopy is the cornerstone but sensitivity and its inability to detect drug resistance limits its role in TB controland it has only modest sensitivity and poor positive predictive value. Culture is the gold standard but its results typically not available for 2-6 weeks. We compared the cartridge-based nucleic acid amplification test (CBNAAT) results for diagnosis of pulmonary and extra pulmonary tuberculosis with the conventional methods like sputum smear and culture examination. Material and Methods: We conducted a retrospective study in department of pulmonary medicine, BURDWAN MEDICAL COLLEGE BURDWAN, WEST BENGAL, and RAJENDRA INSTITUTE OF MEDICAL SCIENCES, RANCHI, JHARKHAND, INDIA to analyse the result of CBNAAT in diagnosis of tuberculosis from Jan2017- Dec 2017. Data was collected from DOTS centre and CBNAAT centre. A total no of 200 cases were studied. Results: Total 200 samples for CBNAAT taken for this study. Mean age of the study population was 30.3±9.24 years. Of these 200 samples, 173 were sputum/BAL samples and 27 were extra pulmonary samples. We found rifampicin resistance rate of 4.6% (8/173) in pulmonary tuberculosis cases, no rifampicin resistance detected in extra pulmonary samples. CBNAAT could identify 43 cases (24.8%) that were smear negative. We found TBHIV coinfection rate of 3.33%. 38(21.96%) Sputum/BAL samples were AFB smear positive and 135(78.03%) % were negative. Chi square test was applied; P value is <0.001. For pulmonary samples, the sensitivity and specificity for CBNAAT samples were 80.2% and 90.6% respectively; while that for sputum smear were 42.6% and 98.1% respectively. For extrapulmonary samples, the sensitivity and specificity for CBNAAT samples were 84.9% and 94.2% respectively; while that for sputum smear were 61.3% and 100% respectively. Conclusions: We found CBNAAT is an important diagnostic modality especially in sputum negative patients for early diagnosis and treatment in lesser time as compared to conventional sputum microscopy. It also detects the rifampicin resistance with high specificity to start early treatment.
Authors and Affiliations
Manish Kumar Munda, Jitendra Singh, pramod Kumar, Shashi Kant Suman
Keywords
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- EP ID EP406777
- DOI 10.9790/0853-1711015052.
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