Uzoewulu Ngozi G
University of Benin,Nigeria
Title: Sensitivity of direct smear microscopy for the diagnosis of TB in high HIV prevalent population Nnewi
Biography
Biography: Uzoewulu Ngozi G
Abstract
Background: Diagnosis of tuberculosis (TB) amongst HIV patients is a great challenge due to the low density of Acid Fast bacilli (AFB) in their sputum. Objective: The study was conducted to determine the sensitivity of direct smear microscopy (DSM) for TB diagnosis in HIV endemic setting using culture as a gold standard. Method: Sputum specimen of 550 TB suspects were screened microscopically for AFB using Ziehl-Nielsen method at NAUTH Nnewi and positive samples subjected to culture on Lowenstein-Jensen medium with each patient also screened for HIV status. Result: They comprised of 238 (43%) DSM TB positive cases and 312 (57%) DSM TB negative cases. Out of 238 DSM TB positive cases, 180(33%) were culture positive cases with 12(2.1%) culture negative cases, 13(2.4%) contaminated specimen, 3(0.5%) NTM and 30(5.5%) lost specimen resulting in 58 (10.5%) specimen which were excluded from analysis respectively. Among the 180 culture positive TB cases 34(19%) were HIV-positive patients while 146(81%) were HIV Negative culture positive TB cases, 109(61%) males as compared to 71(39%) females within 21-40 years age group mostly affected. Findings from this study showed that the difference in the detection of PTB between these two methods was statistically significant (p=0.0001), identifying high sensitivity case detection rate of DSM as compared to specificity by culture detection more especially in HIV positive persons. Conclusion: To improve TB case detection for effective treatment, we recommend the use of culture as back up to enhance the specificity and accuracy of DSM especially in HIV positive persons.