Why Should We Concentrate?
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2018, Vol 17, Issue 12
Abstract
Background: Sputum smear microscopy is the backbone of the Revised National Tuberculosis Control Programme. It is an easy, safe and effective diagnostic method for pulmonary tuberculosis. But, it involves three patient visits to the hospital. We encounter a lot of initial defaulters and, therefore, we need a method to decrease the patient visits without compromising on the results. We compared spot concentrated AFB smear versus spot and home RNTCP AFB smear, and we found the additional diagnostic yield by concentrating spot and home RNTCP specimen and analyzed the results. Materials And Methods: This is a prospective study of 500 tuberculosis suspects who came to the Outpatient Department of the Institute of Thoracic Medicine, Chennai. Persons who were not able to bring out sputum and individuals with hemoptysis were excluded from the study. All consenting participants were asked to give goodquality spot and early morning sputum of about 5 mL, each of which was divided into two equal parts. Part 1 was subjected to concentration by the liquid ammonia technique and stained with Ziehl Nielsen stain. Part 2 was smeared as per the regular RNTCP technique. Results: The results of 500 tuberculosis suspects were analyzed. Spot RNTCP AFB smear diagnosed 49 cases. Home RNTCP AFB smear, Spot concentrated AFB smear and Home Concentrated AFB smear diagnosed 54 cases each. It was found that Spot concentrated AFB smear is as good as Home RNTCP AFB smear. There is no difference between the Spot concentrated AFB smear and the Home concentrated AFB Smear results. Comparing Spot RNTCP AFB smear and Spot concentrated AFB smear, there was a statistical association (P < 0.001), which was highly significant. Clinical Implication: In diagnosing pulmonary tuberculosis cases, Spot concentrated AFB smear alone itself is as good as RNTCP spot and Home specimens combined. The number of visits required for diagnosing and initiating treatment is reduced. The problem of initial defaulters is also reduced.
Authors and Affiliations
N. Murugan, A. Sundararajaperumal
Keywords
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- EP ID EP423858
- DOI 10.9790/0853-1712070105.
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