Abstract
The study was conducted with the objectives to compare the Acid Fast Bacilli (AFB) staining and Culture for the diagnosis of extra-pulmonary tuberculosis and to find out the burden of extra-pulmonary tuberculosis from the different site of the body in suspected TB patients. The standard Ziehl-Neelsen Technique was done for AFB staining and culture was done in Ogawa Medium. Of the 292 extra-pulmonary samples examined by AFB smear only 2(0.7%) were positive and of the 1058 extra-pulmonary samples cultured 20 (1.9%) were positive. The isolation rate for extra-pulmonary samples was three fold higher in culture in comparison to AFB Smear. The confirmation rate of extra-pulmonary tuberculosis was approximately 1/ 8th of the pulmonary tuberculosis by conventional bacteriological diagnostic methods. Of the extra-pulmonary tuberculosis renal, endometrial or pelvic and cold abscess were common in this study. M.tuberculosis was also isolated from peritoneal fluid, pericardial fluid, Synovial fluid, lymph node and cerebro spinal fluids only by culture. In conclusion, the standard AFB culture has significant role for diagnosis of extra-pulmonary tuberculosis, even though the conventional bacteriological technique could diagnose very low number of extra-pulmonary tuberculosis. The new methods of diagnosis should be considered to confirm more extra- pulmonary tuberculosis.Key Words: Extra-pulmonary tuberculosis, AFB Smear, Culture, Diagnosis, Nepal.
Highlights
It is estimated that 1.7 billion individuals are infected with M. tuberculosis
It is estimated that South Asian Association for Regional cooperation (SAARC) region has 2.5 million new cases and 0.6 million death per year
Extra-pulmonary tuberculosis was generally observed most often in immunosupressed patients but 34% of cases were observed in people without any underlying diseases or risk factors
Summary
It is estimated that 1.7 billion individuals are infected with M. tuberculosis. Every year 8 million people get infected. Ninety five percent of the cases are in developing countries and approximately 3 million patient die each year.[1] South Asian Association for Regional cooperation (SAARC) region bears 22% of the global population and 29% of the global burden of tuberculosis. Nepal is among the poor developing countries in SAARC region with population of 23 million and it gets 201 tuberculosis cases per 100,000 populations of which 90/100,000 is smear positive tuberculosis.[2]. Extra-pulmonary tuberculosis was generally observed most often in immunosupressed patients but 34% of cases were observed in people without any underlying diseases or risk factors. The present study was done with the objectives to compare the detection rate of the extra-pulmonary tuberculosis in different site of the body by AFB smear and culture and to find out the common extra-pulmonary tuberculosis among the suspects
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