Prevalence of Endometrial Tuberculosis among Patients Undergoing Endometrial Biopsy at Tikur Anbesa Specialized Hospital, Addis Ababa, Ethiopia

Abdissa, Sileshi (2013) Prevalence of Endometrial Tuberculosis among Patients Undergoing Endometrial Biopsy at Tikur Anbesa Specialized Hospital, Addis Ababa, Ethiopia. Masters thesis, Addis Ababa University.

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Abstract

Background: Female genital tuberculosis (FGTB) is known to cause severe tubal disease leading to infertility and its incidence parallels closely with the overall prevalence of tuberculosis (TB) in a community. Its magnitude is underreported because diagnosis is difficult and requires invasive techniques. Investigation with advanced microbiological techniques may allow for easier, fast and correct diagnosis and treatment that may help to prevent complications. Objective: The aim was to determine the prevalence of endometrial tuberculosis among women who underwent endometrial biopsy for evaluation of various conditions at a referral hospital and characterize the isolates. Materials and Methods: A cross-sectional study was conducted on women for whom endometrial biopsy was done for the diagnosis and treatment purpose of different gynecologic problems at Tikur Anbessa Specialized Hospital (TASH), Gynecology outpatient Department (OPD), up on informed consent. During the data collection period, December 2011 to August 2012, a total of 152 participants were included in the study. The leftover biopsy samples were processed for culture on Löwenstein-Jensen media and subjected to DNA extraction and direct PCR using IS1081 primer pair. The culture isolates were further analyzed using deletion typing for species identification and multiplex PCR for genus typing. Result: IS1081-PCR identified 7/152 (4.6%) biopsies as endometrial tuberculosis. Only four of the seven (4/152, or 2.6%) were positive by culture. The prevalence of endometrial Tuberculosis (TB) was thus 2.6% (4/152) but 4.6% (7/152) with IS1081-PCR. However, histological examination identified only 2/152 (1.3%) as suggestive of endometrial tuberculosis. Only one of these samples was positive with both IS1081-PCR and culture. All of the four isolates were M. tuberculosis. The agreement between the clinical diagnosis and IS1081-PCR and/or culture, was found to be 0.28. Taking culture as gold standard, the sensitivity and specificity of IS1081-PCR and histology were 100% and 98%, and 25% and 50% respectively. Conclusion: We have shown that M. tuberculosis is relatively frequently encountered in endometrial biopsy but the true magnitude of endometrial TB requires thorough investigation and may be missed with histopathological examination alone.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Endometrial TB, Genital TB, Histopathology, IS1081-PCR, Mycobacterial culture, Mycobacterium tuberculosis
Subjects: Q Science > QR Microbiology
Q Science > QR Microbiology > QR180 Immunology
Divisions: Africana
Depositing User: Vincent Mpoza
Date Deposited: 26 Oct 2018 14:28
Last Modified: 26 Oct 2018 14:28
URI: http://thesisbank.jhia.ac.ke/id/eprint/7067

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