Browsing by Author "Abebe, Markos"

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    Female Genital Tuberculosis in Ethiopia: Occurrence and Immunodiagnosis
    (Addis Ababa University, 2001-06) Abebe, Markos; Lakew, Mekuria (PhD)
    Female genital tuberculosis (FGTB) causes severe and irreversible damage to the reproductive organs, most commonly the fallopian tubes and the uterus, ultimately resulting in infertility. Diagnosis of FGTB is often difficult because of the inaccessibility of the affected organs, requiring invasive procedures including surgery. There is a strong need for a simplified and reliable diagnostic technique. This is even more urgent today than in the past because of the spread of HIV / AIDS and the unknown magnitude of FGTB under the current epidemic situation. We studied twenty-five gynecological patients diagnosed clinically as FGTB at the Black Lion Hospital for laboratory evidence of etiology and for possible associated immunodiagnostic indicators. Biopsy and curettage samples were taken from each patient and investigated with histopathology, smear microscopy, culture and polymerase chain reaction (PCR) for Mycobacteria. Culture positive samples were examined for the type of species. Peripheral blood mononuclear cells were stimulated in vitro with mycobacterial antigens for recall responses with lymphocyte stimulation Test (LST). Cytokines: IL-IO, TNF-a and INF-y were measured from the supernatant of cultured PBMC. CD4:CD8 ratio in blood was evaluated by flow cytometry. Serum IgG, IgA and IgM levels to Mycobacterial antigen (MPT59) were also measured by ELISA. The study subjects were all in child bearing age (18-39). Of the 17 patients whose infertility status was known, 6 (35.3) had primary while II (64.7) had secondary infertility... Among the 25 gynecological patients investigated, only I was AFB smear positive, 3 were culture positive, 7 were histology positive and 12 were positive by PCR (a total of 16 positives). CD4:CD8 ratio was not helpful indicator for FGTB. The serum antibody level did not distinguish between laboratory 'positive' and 'negative' cases. However, all 'patients' had detectable level of one or more of serum IgG, IgA and IgM to MPT59. 'Patients' and 'controls' showed remarkable difference in their proliferative response to PPD suggesting its diagnostic value. The result clearly showed that FGTB is a rather common clinical problem among Ethiopian gynecological patients and its causative agent is mainly MTB. As far as this work goes, the only diagnostic method to support the clinical suspicion is the LST to PPD.