ZIEHL-NEELSEN MICROSCOPY IN THE DIAGNOSIS OF TUBERCULOSIS IN SETTINGS OF HIGH HUMAN IMMUNODEFICIENCY VIRUS PREVALENCE
| Autor: | H D N, Nyamogoba, G, Kikuvi, S, Mpoke, P G, Waiyaki, D, Van Soolingen |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male Adolescent HIV Infections Sensitivity and Specificity Immunocompromised Host Predictive Value of Tests Prevalence Humans Tuberculosis Child Coloring Agents Tuberculosis Pulmonary Aged Aged 80 and over Microscopy AIDS-Related Opportunistic Infections Staining and Labeling Sputum Infant Mycobacterium tuberculosis Middle Aged Kenya Cross-Sectional Studies Child Preschool Female |
| Zdroj: | East African medical journal. 89(8) |
| ISSN: | 0012-835X |
| Popis: | To determine the accuracy of Ziehl-Neelsen microscopy in the diagnosis of TB in setings of high HIV prevalence.Cross-sectional descriptive study.Hospitals serving areas of high human immunodeficiency virus prevalence in western Kenya. The study was conducted between September 2007 and September 2009.In total, 341/872(39.1%) of the TB suspects were positive in ZN, 53.1% (181/341) of them culture positive. Only 3.8% (20/531) of the ZN smear negatives were culture positive. Of the 695 suspects evaluated for both Mycobacterium and HIV infection, 255 (36.7%) were ZN smear positive, 42.7% of them HIV positive. Out of the 440 ZN smear negatives, 37% were HIV positive. Similarly, 168 suspects were culture positive, 46.4% of them HIV positive. The HIV infection did not significantly reduce ZN smear positivity rate (P = 0.42) and culture sensitivity (P = 0.09). The ZN sensitivity and specificity were 88.1% and 79.7%, respectively. The predictive values were 58.0 (PPV), and 95.5% (NPV), respectively. However, the area under the ROC curve was 0.84, with 95% CI between 0.80-0.87 and P0.001). The ZN smear microscopy had a lesser ability to distinguish between TB and non-TB cases compared to culture.ZN microscopy causes a significant over-diagnosis of TB in settings of high HIV/AIDS prevalence. There is need for further studies on this subject taking into consideration the various confounding factors. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|