Introduction: Tuberculosis remains a worldwide public health problem despite the highly effective drugs and vaccines are available making tuberculosis a preventable and curable disease. The objective of this study was to compare the different laboratory diagnostic methods of tuberculosis and determine its prevalence. Methodology: Morning sputum samples were collected from suspected cases of pulmonary tuberculosis and preceded for Ziehl Neelsen staining, fluorescent staining (auramin-O) and mycobacterium culture in Lowenstein Jensen medium. Results: Total 78 suspected cases of pulmonary tuberculosis were included in this study among them 53 were male and 25 were female. Out of 78 cases, 46 cases were found to be culture positive. In culture positive cases (83%) were found to be M. tuberculosis and (17%) were found to be slow grower, fine colonies, AFB positive but niacin test negative (mycobacteria other than M. tuberculosis). In the direct microscopic examination by Ziehl Neelsen stained smear 26 samples were found to be acid fast bacilli and one sample was culture negative but acid fast bacilli positive. In fluorescent stained smear 34 samples were found to be positive for acid fast bacilli and 5 samples were culture negative but acid fast bacilli positive. Culture was accepted as gold standard, the sensitivity of direct microscopic examination was found 56.5% for Ziehl Neelsen staining and 73.9% for fluorescent staining respectively. Conclusion: In culture positive cases M. tuberculosis and mycobacteria other than M. tuberculosis was found to be 83% and 17% respectively, it was found higher in male than female. Fluorescent microscopy is superior to Ziehl Neelsen microscopy but gives more false positive result than Z-N staining. Combining of Ziehl Neelsen and fluorescent staining is better than fluorescent staining alone.DOI: http://dx.doi.org/10.3126/saarctb.v11i2.12427 SAARC J TUBER LUNG DIS HIV/AIDS, 2014;XI(2), page: 1-6
Tuberculosis is a particular infectious disease caused by Mycobacterium tuberculosis .The disease primarily affects the lungs and cause pulmonary tuberculosis diagnosed with smear positive. The prospective case-control study was conducted in the Nepal Anti-Tuberculosis Association (NATA), GENETUP lab, Kalimati, Kathmandu from July 2010 to October 2010, on sputum samples from patient visiting at the GENETUP lab with suspected pulmonary tuberculosis cases without treatment and follow-up cases after DOTS and MDR treatment. A total of 299 sputum samples (170 from 78 suspected cases, 42 from 22 follow-up cases with DOTS treatment and 87 from Follow-up cases with MDR) were collected aseptically. The study clearly indicated that the case detection rate (efficacy) of fluorescent microscopy (AO stain) is remarkably higher than that of ZN (light microscopy) ,with aided advantages of less eye strain, easy visualization, less time consuming and even detection of low number of bacteria (paucibacillary cases) in comparison to ZN method. the correct diagnosis of pulmonary tuberculosis requires combination of AO (fluorescent microscopy), culture and biochemical analysis.
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