The Aetiological Causes of Tuberculous Lymphadenitis in Butajira, Ethiopia

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Addis Ababa University


The utility of MPB70 antigen in serodiagnosis of Mtuberculosis complex infection and the polymerase chain reaction (PCR) for rapid identification of the causative agent if cervical lymphadenitis were investigated. The PCR assay was based on detecting a 506-bp DNA segment belonging to the alpha 32 kDa antigen (85B) common in the genus Mycobacterium, a 984-bp DNA segment belonging to the insertion sequence IS 6110 specific for the M tuberculosis complex, and a 185-bp pncA gene segment at position 169 allele-specific for genetic differentiation of Mtuberculosis from M bovis. For the ELISA purpose, sera from 25 tuberculous lymphadenitis (TBLN), 14 non-tuberculous lymphadenitis (NTBLN), 11 pulmonary tuberculosis (PTB) patients and 10 healthy control (HC) subjects were tested. For PCR, in 39 clinically diagnosed tuberculous lymphadenitis patients, fine needle aspirates (FNA) were processed and tested. Of these, which 14 were considered as non-tuberculous lymphadenitis by fine needle aspirate cytology (FNAC). Of the 39 clinically diagnosed TBLN, 27 (69%) were positive by ELISA. When this was compared with the assumed gold standard (FNAC), it showed 64% sensitivity, 21% specificity, 49% efficiency, 59% positive predictive value and 25% negative predictive value. With PCR, 29 (74%) of 39 were positive, showing 72% sensitivity, 21 % specificity, 54% efficiency, 62% positive predictive value and 30% negative predictive value. When it was compared with FNAC.Of the 29 PCR positive for genus Mycobacterium and Mtuberculosis complex, 18(62%) of them were identified as M tuberculosis, 3 (10%) of them were M. bovis and 8 8%)of them were found co-amplifying M.tuberculosis and M. bovis. These data indicated that both serodiagnosis with MPB70 antigen of the M.tuberculosis complex and peR assay are useful for rapid identification of tuberculous lymphadenitis and better management of patients.