Journal of Thyroid Disorders & Therapy
Open Access
ISSN: 2167-7948
+44 1300 500008
ISSN: 2167-7948
+44 1300 500008
Samuel Alomatu
Walter Sisulu University, South Africa
Scientific Tracks Abstracts: Thyroid Disorders Ther
Statement of the problem: This study derives motivation from the fact that cases of suspected TB pericarditis are started empirically on TB treatment without any laboratory confirmation, and it becomes challenging to know whether the pericarditis was caused by TB as most cultures for TB takes a month to get results, by then patients would have even been discharged from hospital. A point of service care test is needed to guide clinicians in deciding to start anti TB treatment in pericarditis or to screen patients for other possible causes of pericarditis. Therefore, this study was carried out to assess the efficiency of a point of care diagnostic test which is TB LAM Ag test that can be used to diagnose TB pericarditis. Methodology & theoretical orientation: This was a cross-sectional study. We enrolled all patients with suspected TBP comprising of males and females above 18 years between July 2019 and July 2020. A total of 46 consecutive patients presented within the study period. In total 46 participants took part in the study. These were patients with suspected TBP who come to Nelson Mandela Academic Hospital in Mthatha by themselves or were referred from neighbouring local hospitals. Findings: Fifteen (34.1%) patients were diagnosed with TBP according to culture results. TB LAM Ag's sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (PLR), and negative likelihood ratio (NLR) were 33.3%, 100%, 100%, 74.4%, 0, and 0.67, respectively. The sensitivity, specificity, PLR, NLR, PPV, and NPV of Xpert MTB/RIF Ultra were 80%, 93.1%, 11.6, 0.21, 85.7%, and 90% respectively. Conclusion: PCF TB LAM Ag has better specificity, PPV, and NLR, but lesser sensitivity, NPV, and PLR compared to Xpert/MTB/RIF Ultra for the diagnosis of microbiologically confirmed TBP. PCF TB LAM Ag showed increased sensitivity in positive HIV status and low CD4 cell counts but its sensitivity is irrespective of participants’ age. Xpert/MTB/RIF Ultra showed increased sensitivity in negative HIV status and older age but reduced specificity in low CD4 cell counts. PCF TB LAM Ag showed no additive value when performing Xpert/MTB/RIF Ultra for the diagnosis of TBP. A positive TB LAM Ag test in PCF samples necessitates immediate TBP treatment. If the TB LAM Ag test is negative, it should never be used to rule out TBP; nevertheless, it should be used in conjunction with the Xpert MTB/RIF Ultra and other PCF tests such as the ADA or interferon-gamma assay test to establish the absence of TBP. However, for the diagnosis of TBP, a TB LAM Ag test using PCF is recommended.
Samuel Alomatu studied human biology and Bachelor of Medicine and Surgery at the University for Development Studies, Tamale in Ghana. He then went on to do post-graduate specialty course at Walter Sisulu University in South Africa and obtained Master of Medicine in Internal Medicine and, he is a Fellow of the college of Physicians South Africa. He is currently a lecturer in the department of internal medicine at Walter Sisulu University. He has been involved in research activities including INVICTUS TRIAL which was published in NEJM last year.