Application of serial tests for Mycobacterium tuberculosis detection to active lung tuberculosis cases in Indonesia

Abstract

Objective Rapid detection and accurate diagnosis are very important in managing active tuberculosis because they provide an advantage in preventing further disease transmission. In accordance with the recommendation of the World Health Organization, the Indonesian Tuberculosis Control Program uses the acid fast bacilli (AFB) smear and Chest X-ray methods as the primary methods for detecting tuberculosis, especially in new cases of suspected tuberculosis. The genus Mycobacterium has many species, strains, and variants, and their natural differences may affect the clinical outcome of the diseases they induce. The purpose of this study was to assess different tuberculosis detection methods as part of serial tests and determine the best diagnostic approach for detecting active lung tuberculosis in Indonesia. Results This study used clinical samples from tuberculosis patients and assessed them using a series of tests, aiming to increase the sensitivity of active tuberculosis detection. Some samples that yielded negative results in the AFB smear test were detected as positive for Mycobacterium tuberculosis using the nucleic acid amplification test, with a sensitivity of 83.1%. Additionally, nucleic acid amplification also detected positive results among samples assessed as M. tuberculosis -negative using the culture method, this method yielded the same results as the Gene Xpert test.

Soluble CD14 and Th 17-Related Interleukins in Bronchoalveolar Lavage Fluid are Potential Triage Biomarkers for Pulmonary Tuberculosis

“…Bacteriological con rmation based on sputum and BALF using acid fast bacilli smear, Xpert test and Mtb culture can be realized in about 80% of PTB patients [6,10]. In this study, 79.6% (82/103) of active PTB, including 32.0% (33/103) based on sputum and 47.6% (49/103) depended on BALF further, were bacteriologically con rmed, suggesting that our cohort of patients is a typical example of the current status and suitable for biomarker study.…”

“…The principal techniques for detection of the Mtb in sputum and tissue samples are culture (the gold standard), microscopy (acid-fast smear) and nucleic acid ampli cation tests (NAAT). Unfortunately, the sensitivity of common sputum microscopy is about 15%-30% though it is signi cantly raised by the assistance of sputum induction and sputum NAAT (Xpert MTB/RIF) and culture [5][6][7]. Compared with sputum, bronchoalveolar lavage uid (BALF) collected by beroptic bronchoscopy has much higher sensitivity for Mtb detection [8,9].…”

“…Empiric antibacterial therapy was the major cause of anti-TB delay in this study. The nature of the triage effect of moderate levels of these biomarkers on empiric antibacterial therapy is perhaps because PTB (smear/NAAT-positive patients) rather than non-PTB patients with higher levels of those biomarkers were selected out by acid fast bacilli smear and Xpert test based on sputum and BALF.Xpert and Mtb culture are key measures to increase the microbiologic diagnosis rate in smearing-negative PTB[6][7][8][9][34][35][36]. However, Xpert test is relatively expensive and cannot be broadly used in developing countries and Mtb culture not only needs sophisticated research-type laboratories, but also is timeconsuming[11,12,37].…”

Analysis of Factors Related to Personal Behaviour of Hygiene on the Ship Crew in PT Salam Pasific Indonesia Lines Surabaya

“…Implementation of health-oriented development requires various types of health workers who have the ability to conduct health efforts with a healthy paradigm that is more priority to efforts to improve and maintain health and prevent disease. Disease prevention activities also require health resources (13,14). The availability of facilities and infrastructure is very supportive for the crew to always maintain personal hygiene behaviour.…”

Factors Affecting Uric Acid Changes in Pulmonary Tuberculosis Patients Who Received Oral Anti Tuberculosis Therapy During One Month

“…Tuberculosis (TB) is still a serious health problem in both developing and developed countries and the incidence is rising countinously [1][2][3] . In 1993, the World Health Organization (WHO) declared TB as "Global Emergency" and at that time it was estimated that there were about 7-8 million cases where 1.3-1.6 million deaths annually.…”