Laboratory Investigations on the Diagnosis of Tuberculosis in the Malnourished Tribal Population of Melghat, India

Abstract

BackgroundMalnutrition is a major risk factor for the development of tuberculosis (TB). In India, Melghat is among the tribal regions which consist of highest number of malnutrition cases. Because of the paucity of TB data from these malnourished areas there is an urgent need for the development and evaluation of improved TB diagnostic tests. In the present study, three in house developed diagnostic tests namely TB-Ag(antigen) ELISA, Adenosine deaminase (ADA) estimation and IS6110 polymerase chain reaction (PCR) assay were investigated for the detection of Mycobacterium tuberculosis (M. tb.) infection.MethodsFor investigation, blood samples were collected from 128 study subjects from six villages of Melghat tribal area and evaluated using three in house developed assays, namely TB-Ag ELISA, ADA estimation and IS6110 PCR.ResultsThe TB-Ag ELISA method yielded 83% sensitivity and 94% specificity. The ADA and PCR assay gave a sensitivity of 61% and 49% and specificity of 62% and 98% respectively. A considerable good agreement of 82.81% (k=0.472) between TB-Ag ELISA and PCR was observed. The overall sensitivity of TB-Ag ELISA was significantly higher (p<0.05) than the ADA and PCR while PCR yielded highest specificity among all the three evaluated tests.ConclusionsWe concluded that the routine use of TB-Ag ELISA can be useful for screening of suspected TB patients in the malnourished population where sophisticated laboratory set up is difficult.

Polymerase chain reaction detection of LeishmaniaDNA in skin biopsy samples in Sri Lanka where the causative agent of cutaneous leishmaniasis is Leishmania donovani

“… Salotra et al (2001) reported no LdF/LdR primers cross-amplification with M. tuberculosis DNA using blood samples from patients with pulmonary TB. The reported sensitivity of PCR in detecting M. tuberculosis DNA in blood of pulmonary and extra-pulmonary TB patients was low (< 50%) ( Crump et al 2012 , Kashyap et al 2013 ). Therefore, the negative results reported could have been most likely due to false negatives or absence of M. tuberculosis DNA in the tested blood samples (true negatives).…”

Differential Levels of Alpha-2-Macroglobulin, Haptoglobin and Sero-Transferrin as Adjunct Markers for TB Diagnosis and Disease Progression in the Malnourished Tribal Population of Melghat, India

“…The present study was conducted in the tribal belt of Melghat where malnutrition and TB are the two leading causes of morbidity and mortality [ 7 ]. Our efforts in the identification of biomarkers for active and latent TB in this population have been constant and ongoing.…”

The assessment of cytokines in Quantiferon supernatants for the diagnosis of latent TB infection in a tribal population of Melghat, India

“…Melghat is a hilly forested area located on the outskirts of the Amravati District of Maharashtra with a population of 0.3 million. The TB prevalence in the region is estimated to be nearly 32% and is one of the leading causes of death in the economically productive age group of 16-40 years [15]. According to the reports of United Nations Children's Fund (UNICEF), National Family Health Survey (NFHS) and Meditation Addiction Health AIDS Nutrition (MAHAN), Melghat also has the highest number of malnutrition cases in India [16].…”