Comparison of direct microscopy (ziehl neelsen) and light-emitting diode fluorescent microscopy) against Xpert MTB/RIF for the diagnosis of pulmonary tuberculosis and assessing facility infrastructure in Assosa general hospital Benishangul- gumuz region, Western Ethiopia
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Date
2019-12-02
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Addis Ababa University
Abstract
Background: Globally TB is associated with a lot of morbidity and mortality .More so in high burden like Countries like Ethiopia and other African Countries where high prevalence of HIV has further compounded this problem leading to resurgence of TB. Moreover, the emergence of MDR- and XDR-TB coupled with inefficient diagnosis is a major challenge to TB control leading to TB being one of the major public health problems in poor resource countries like Ethiopia.
Objective: This study aimed to evaluate performance of smear microscopy with X-pert/Rif and facility infrastructure assessment was carried out in Benishugul regional sate, Assosa General Hospital, western Ethiopia
Methods: Hospital based cross-sectional and descriptive study was conducted on a total of 331 sputum samples collected from Assosa General Hospital. The sputum samples were analyzed using gene expert, ZN and FM methods. Kappa value, Sensitivity, Specificity, Positive Predictive Value (PPV) and Negative Predictive Value (NPV) of iLED-FM and ZN were calculated against the gene xpert. And real practice of current Tb laboratory diagnosis was assessed from nineteen periphery health centers
Results: The sensitivity, specificity, PPV and NPV of LED-FM was 97%, 100%, 100% and 100% respectively. The measure of agreement and percent agreement between the LED-FM and reference standard results were substantial with kappa value (k=0.99) and 99 respectively. The sensitivity, specificity, PPV and NPV of ZN when compared to Gene expert, were 81%, 100 %, 100 %, 99% respectively with percent agreement 89 and kappa value of 0.89
Conclusion: The overall performance of LED microscopy is superior compared to ZN TB microscopy. The sensitivity and specificity of LED is comparable with GeneXpert and use of combined LED –Gen-expert methods can increase case detection of PTB particularly in resource limited settings.
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I, the undersigned, declare that this M.Sc. thesis is my original work, has not been presented for a degree in this or any other university and agree to accept all responsibilities for the scientific and ethical conduct of the research project. I was providing timely progress report to my advisor and seek the necessary advice and approval from my primary advisors in the course of the Research that all sources of materials used for the thesis have been duly acknowledged
Keywords
Level of agreement, comparison with gene expert, LED Microscopy, Facility infrastructure assessment