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Title: Comparative Assessment of Five Laboratory Techniques in The Diagnosis of Pulmonary TB in Abuja

Authors: Ochei Kingsley chinedum, Obeagu Emmanuel Ifeanyi,

Topic: Public Health


A total of 340 specimens from 192 (56.5%) male and 148 (43.5%) females attending tuberculosis clinics in Abuja metropolis were analysed by five different laboratory techniques (ZN Direct, ZN Bleach, LJ slants, BACTEC and Serology TB) for the diagnosis of Mycobacterium tuberculosis. Comparative analysis of results at P=0.05, revealed that there was a statistical significant (X2=127.1, P<0.001) difference between the diagnostic performance of the five laboratory techniques. A follow-up analysis based on the 95% confidence interval of pair differences in proportion between the five techniques indicated that the BACTEC assay was the major source of the difference(P<0.001) in pair methods. Comparism of the 95% confidence limit of pair differences in diagnostic specificity of Mycobacterium tuberculosis between ZN-BACTEC and other methods confirmed (P<0.001) the high detection rate of BACTEC. It was observed that BACTEC had the highest detection rate (61.2%), followed by LJ (31.2%), then ZN Bleach (30.3%) and ZN Direct (28.8%), while Serology had only 25.3% ZN BACTEC appeared to the most reliable, and time effective combination. ZN Bleach should be encouraged in poor resource settings in lieu of the conventional three standard smears for ZN Direct. The use of Serologic TB kit alone for the diagnosis of tuberculosis should be discouraged.


    COMMENT - 1

  • EBENEZER OBI DANIEL (Viewer) 28th Jan 2015 - 2:20 PM
    I commend you on this research work. But I want to know the sampling procedure and the criteria adopted in selecting the males and female participants. This is necessary for generalization of result.

  • COMMENT - 2

  • TALKMORE MARUTA (Viewer) 29th Jan 2015 - 11:27 AM
    Well described research with enough detail on the procedure followed.

    In the discussion, it could help to compare or link your findings with other findings for similar methods e.g., your sensitives, detection rates etc. Where there could be differences between your study and others, provide or propose the reason for such a difference.

    On the results section or method section, a more explanation on what is the "pair method" could help others understand/have meaning of your findings using that statistical calculation in your results

  • COMMENT - 3

  • KINGSLEY CHINEDUM OCHEI (Author) 30th Jan 2015 - 2:10 PM
    Hello Daniel, random sampling was utilized.

  • COMMENT - 4

  • KINGSLEY CHINEDUM OCHEI (Author) 30th Jan 2015 - 2:15 PM
    Yes Talkmore, the comparison was there in the original context but after several reviews was pruned.
    The paired method refereed to the use of 2 of the methods in comparison with another 2 to see the correlation and result out put. Most laboratories may not have capacity for all methods to do some check and balances. but if a laboratory can invest on 2 methods that are cheaper and can give reliable result as the very expensive method, that will suffice. This is what the paired method aimed to achieve.

  • COMMENT - 5

  • ABDULLAHI BUKAR (Viewer) 1st Feb 2015 - 1:20 AM
    This good study use of BACTEC is one of mainstay in molecular diagnosis of Mycobacterium tuberculosis, however its feasibility or availability and how cost effective are things we need to recommend in the context of Nigeria setting, where ZN staining is the main laboratory diagnosis test used for detecting of MTB

  • COMMENT - 6

  • Tamuzi Lukenze Jacques (Viewer) 5th Feb 2015 - 10:14 PM
    Could you please tell me which method of random sampling was used: computer, coin...

  • COMMENT - 7

  • NZASI MUNDABI (Viewer) 7th Feb 2015 - 5:38 AM
    The Xpert MTB/RIF assay has been CE-marked for rapid molecular diagnosis of TB in Europe and has been endorsed by the WHO as a replacement for sputum smear microscopy for diagnosis of pulmonary TB in low- and middle-income countries. What about you?