Chemeda, Alemu (2015) Use of Urine as an Adjunct Specimen for the Diagnosis of Pulmonary Tuberculosis in People Living With HIV in Addis Ababa. Masters thesis, Addis Ababa University.
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Abstract
Background: Tuberculosis is an opportunistic infection that increases the mortality and morbidity in human immunodeficiency virus (HIV) infected individual. The diagnosis of pulmonary tuberculosis (PTB) is usually established by examination of three Zeihl-Neelsen (ZN) stained smears but in HIV infected persons, ZN staining mostly shows negative smear, which do not preclude Pulmonary TB. Since tubercle bacilli or their nucleic acids are expected to be excreted through the kidneys, we were interested to assess spot urine as a supplementary specimen for diagnosing of pulmonary TB. Objectives: The aim of this study was to evaluate urine as an adjunct specimen for the diagnosis of pulmonary tuberculosis in people living with HIV by using different diagnostic methods. Method: A cross-sectional study was conducted on PTB suspected patients infected with HIV from November 2013 to January 2015. A total 234 specimens (117sputum & 117urine) were collected from 117 PTB suspected cases. The collected samples were processed for culture using Lowenstein-Jensen medium and the left were subjected to PCR using RD9 primers. The culture isolates were further analyzed using deletion typing for species identification and multiplex PCR for genus typing and the isolates were characterized using Spoligotyping. Result: Out of 117 PTB suspected HIV infected individuals, sputum culture alone detected more mycobacterial isolates 33 (28.2%) than the urine specimen alone17 (14.5%). Of the 84 sputum culture-negative cases, four (4.8%) were urine culture-positive. Among patients whose pulmonary samples were negative by all bacteriological methods, the urine PCR was positive in 5.2% of the patients. The combination of urine culture and PCR result was comparable with the result of sputum culture with the sensitivity, specificity, PPV and NPV of 87.9%, 100%, 100%, and 79.2% respectively. In our study, the majority of the isolates (86.8%) belonged to two major families: Family33(43.4%) and T family(43.4%). Conclusion: PCR and culture examination of urine specimen from PTB suspected patients significantly improved the detection rate of M.tuberculosis. The distribution of M.tuberculosis isolated from both urine and sputum specimens of the same patients showed difference with 53.8% in their family.
| Item Type: | Thesis (Masters) |
|---|---|
| Uncontrolled Keywords: | Tuberculosis; Pulmonary tuberculosis; TB HIV infected, Diagnosis; Urine; PCR |
| Subjects: | Q Science > Q Science (General) Q Science > QR Microbiology Q Science > QR Microbiology > QR180 Immunology |
| Divisions: | Africana |
| Depositing User: | Vincent Mpoza |
| Date Deposited: | 28 Jun 2018 10:53 |
| Last Modified: | 28 Jun 2018 10:53 |
| URI: | http://thesisbank.jhia.ac.ke/id/eprint/6130 |
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