The Yield of Sputum Smear Direct Microscopy Using Ziehl-Neelsen Stain in Comparison with Lowenstein Jensen Culture on the Diagnosis of Pulmonary Tuberculosis in Tripoli-Libya

Abstract

Background:In the developing countries, Tuberculosis is one of leading causes of morbidity and mortality. The detection and identification of Mycobacterium tuberculosis is considered a great challenge for clinical microbiologists. Albeit Ziehl-Neelsen (ZN) smear is being a rapid diagnostic tool for TB, the culture on Lowenstein Jensen (LJ) medium is considered the golden diagnostic tool for TB in the developing countries.Objectives: To evaluate the validity and reliability of ZN smear of acid-fast bacilli compared to the culture on LJ medium. Patients and methods:The retrospective analytic comparative cross-sectional study included patients visiting TB OPD clinic at NCDC, including transferred patients from other healthcare facilities and hospitals. A total of 2783 specimen of suspected pulmonary TB cases were processed for both direct smear and culture. The direct smears were stained with ZN method (1% Carbolfuchsin, 3% Hydrochloric acid Ethanol and 0.1% methylene blue). Specimens were observed under 100-x oil immersion lens, whilst cultures were inoculated on LJ medium after digestion and decontamination of the clinical specimens.Results: Of total 2783 study subjects, 203 (7.29%) were smear positive while 327 (11.74%) were culture positive. Out of 203 smear positive pulmonary cases, 154 (47.094%) were found to be positive on LJ culture. A total of 2407 pulmonary cases were negative on the smear and LJ culture for Mycobacterium tuberculosis.Conclusion: This preliminary study indicated the low sensitivity of sputum smear direct microscopy for early diagnosis of TB, while culture on LJ remains the golden standard modality.

Epidemiological Study of Prevalence TB in Iraq

“…The direct smear microscopy method applied frequently in the third world and particularly in Iraq, is one of the methods that can be used to diagnose tuberculosis. Regarding the diagnosis of tuberculosis, the LJ culture medium is usually recognized as the gold standard in underdeveloped nations 8 . In terms of the clinical manifestations that they cause, pulmonary tuberculosis (also known as PTB) and extra-pulmonary tuberculosis (also known as EPTB) are the two most frequent types of tuberculosis (TB).…”

“…Most droplets released from the mouth, nose, and throat when someone talks, or coughs transmit tuberculosis, a respiratory disease. However, tuberculosis can also spread to other body regions, such as the lymph nodes, pleura, belly and urogenital tract 3,4 , skin and joints 5,6 , bones 7,8 , and the meninges. Extra-pulmonary tuberculosis is the name given to the following type of illness.…”

Synthesis, Characterization Gd(Iii) Complex with Heptilmethyl- Ditiocarbamate and 2,9-Dimethyl Phenanthroline as Anti-Tuberculosis

“…This media is a synthetic medium that contains eggs and is enriched with glycerol and asparagine which can fertilize the growth of Mycobacterium tuberculosis (Daulay et al, 2015). In addition, LJ media is considered a superior diagnostic tool in developing countries (Shoukrie et al, 2018) and based on research conducted by Pestariati and Meilinda (2021), showed that LJ solid media has good performance in growing Mycobacterium tuberculosis bacteria in BTA positive microscopic samples.…”