Use of Urine as an Adjunct Specimen for the Diagnosis of Pulmonary Tuberculosis in People Living with HIV in Addis Ababa
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Date
2023-05-23
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Addis Ababa University
Abstract
Background: Mycobacterial tuberculosis is a microorganism which causes a pulmonary disease called tuberculosis, and it enhances the disability and death of an immune compromised person. The diagnosis of it is done by ZN smear, culture, LAM, GeneXpert and radiology. The part of the bacterial antigen (Lipoarabinomannon) (LAN) is excreted by renal, due to this we have a long walk to go on tuberculosis samples to diagnose. To utilize urine as an additional samples.
Objective: Use of urine as an adjunct specimen for the diagnosis of pulmonary tuberculosis in people living with HIV. Methods: A study done on immune compromised persons was a cross-sectional study designwho were suspected PTB from MAY 2022 to May 2023. A total of 800 samples (200 sputa & 600urine) were collected. GeneXpert,MGIT,LJ, LAM and ZN smear methods were employed to analyze the samples. Drug susceptibility test were done by MGIT and GeneXpert/RIF.
Result: Out of 200 PTB suspected HIV patients, [33 %( 66/200)] were sputum culture positive, of which 15 were sputum and urine culture positive. 51 were urine culture negative and sputum positive, 3 samples were become urine culture positive but sputum culture and GeneXpert negative. The risk factors of the study participants smoking was [24%(48/200,OR=1.464)], family history of Tb was [7.9%(16/200,OR=0.917)], crowded house style were [78.2%(158/200,OR=4.9)].Drug susceptibility pattern out of 72 geneXpert/RIF positive patients [19.4%(14/72) were RIF resistance and [4.1%(3/72) were RIF-indeterminate, from MGIT out of 66 MTB positive patients [21.2%(14/66)] were RIF resistance. On LAM out of 18 urine positive patients [16.6%(3/18)] were RIF resistance.
Conclusion: Even if culturing specimens is the golden method to investigate pulmonary tuberculosis, GeneXpert is the fastest and also detect the non-alive mycobacteria. In HIV patients to increase the outcome of being positive of MTB the utilization of urine as an additional specimen is a wise choice.
Key words: MTB. PTB, GeneXpert, LAM, Tuberculosis, smear, culture
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MTB. PTB GeneXpert LAM Tuberculosis smear culture