Reliability of tuberculosis rapid test in diagnosis of pulmonary tuberculosis in Al-Hawija district.

Abstract

Tuberculosis      (TB) is common      in  Iraqg, early   diagnosis,      especially      for  active  pulmonary    cases,   allows  to start  therapy    of the  disease   rapidly.  Pulmonary tuberculosis   is usually  diagnosed     by  presence     of  clinical   features,    direct sputum     smears examination       for  acid    fast   bacillus     (AFB), and    chest    X ray (CXR).    Advances  in serological        assays      for    fuberculosis        have      made serology  an  attractive surveillance  method,   tuberculosis  rapid  test  is one of  these    new    methods.      This employed to detect      antibodies       specific     for mycobacterial      antigens    in the  serum  of suspected  TB patients.   The aim  of this  study   is o   evaluate      the   reliability   of  tuberculosis      rapid    test  in diagnosis of  pulmonary    TB patients   in Al-Hawija  district.  A fifty patients   were   studied between     August   2010  and   February   2011, who   were   then   classified   into two   groups;     a  group    of  pulmonary      tuberculosis      (n  =  30)  and    a  group    of non-tuberculous pulmonary     infection     (control    group)     (n  =  20).   Direct sputum    smears    examination       for AFB, CXR,  and   tuberculosis      rapid    test  were performed       to   all   patients.      The   mean     age     of   pulmonary      TB group     was 37.3+16.4    years    and    17(57%)   patients     of  them    were    men,   while   the   mean age   of the  control   group   was  36+16.2 years  and   11(55%) patients   of them were    men.    Direct   sputum    microscopic       examinations       for  AFB were    positive in 9 (30%) patients   of pulmonary    TB group,   while  none   of the  control   group was    sputum    smear    positive.    The  results   of   the   tuberculosis     rapid    test revealed    that  21(70%) of  pulmonary   TB group   and   3(15%) of  control   group were  positive.   The  sensitivity,   specificity,    positive    predictive     value    and negative      predictive      value    of  tuberculosis      rapid   test   were    70%, 85%,  87.5% and   40% respectively,      which    also   compared       to  sputum    smears    results.

Conclusion:    It was  concluded    that  tuberculosis  rapid  test  in comparison to sputum  smears  examination,   it can  be  used  as a rapid  diagnostic   test of pulmonary    TB along   with traditional   diagnostic    tests in endemic    areas.