The Aetiological Causes of Tuberculous Lymphadenitis in Butajira, Ethiopia
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Date
2001-06
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Addis Ababa University
Abstract
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.
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Biology