Evaluation of Leucocyte Esterase Reagent Strip Test for Rapid Diagnosis of Spontaneous Bacterial Peritonitis in Adult Cirrhotic Patients: A Hospital Based Cross Sectional Study, Addis Ababa, Ethiopia, 2021.

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Addis Abeba University


Introduction: Chronic liver disease is characterized by fibrosis and architectural distortion of the liver. Spontaneous Bacterial Peritonitis is the most common and fatal complication of liver cirrhosis. The standard diagnostic modality of SBP is costly, laborious, and most of all time consuming for resource limited set up. Hence, it is crucial to find an alternative easy, inexpensive and rapid diagnostic modality. Objective: To evaluate the use of leucocyte esterase reagent strip test in diagnosis of SBP among cirrhotic patients in two public and one private hospital in Addis Ababa, Ethiopia, 2021. Methodology: A facility based cross sectional study was conducted from August 15 to September 30, 2021 among adult cirrhotic patients at public and private health centre, Addis Ababa, Ethiopia. Data was collected through self-administered questionnaire and medical records. All patients had undergone paracentesis, and the ascetic fluid was processed for PMN, LERS and culture. The collected data was entered to SPSS version 26.0. Descriptive statistics was presented using tables and figures. Sensitivity, Specificity, PPV and NPP of LERS was calculated and association was assessed using Binary Logistic Regression where P-value and 95% CI for odds ratio are used for testing significance and interpretation of results. Result: Out of 94 study participants, 74 were males and the mean age was 47 9.4. The commonest cause of cirrhosis was HBV (36.2%) followed by ALD (26.6%) and HCV (21.3%). More than half (51) of the patients had CTP B, and 42 CTP C. Electrolyte disturbance, HE, and HRS were identified at a rate of 71.4%, 64.8% and 53.8% respectively. Of the 16 patients who died 11 were secondary to sepsis. SBP was diagnosed in 56 patients by ascetic fluid PMN count as compared to 51 detected by LERS test and 2 by ascetic fluid culture. At a cut off of 2 + , sensitivity, specificity, PPV, and NPV were 81.8%, 94.6%, 94.7%, and 81.4%. In comparison, at cut off level of 3 + ; sensitivity, specificity, PPV and NPV were 60%, 97.2, 92.3%, and 81.4% respectively. The overall accuracy of the test was 88.3% and the LDOR was 70. Conclusion: Our study demonstrated that LERS test is a simple, inexpensive, accessible, and sensitive alternative rapid screening tool for diagnose of SBP. Budget: Overall, a total of 80,500 Ethiopian Birr was utilized to accomplish the thesis work.



SBP, CLD, cirrhosis, Leukocyte esterase reagent strip, ascetic fluid analysis