Abstract
Tuberculosis (TB) is a major contagious disease caused by Mycobacterium tuberculosisand is endemic in many countries of the world. It is estimated that worldwide one third human population are infected with TB. There is little use of sputum culture regarding diagnosis of tuberculosis in TB endemic areas. The undertaken study evaluated the importance of TB sputum culture than other diagnostic tools among the doctors, and patients affected from active infectious pulmonary tuberculosis. The study was carried out at Fatima Jinnah General and Chest Hospital Quetta, Balochistan from January 2008 to December 2008. A total of 2237 suspected TB patient’s samples were sent for the TB diagnosis. Among the suspected TB samples, 244 (10.9%) samples were subjected for TB culture and smear microscopy, in which 119 (48.7%) samples were from female patients, while 125 (51.3%) were obtained from male patients. Of the 244 TB culture samples, 93 (38.11%) were positive, while the remaining 151 (61.8%) cases showed negative culture result. 82 of the 93 culture-positive patients were positive for acid fast bacilli (AFB) on sputum smear microscopy; however 11 samples were negative for AFB on smear analysis but positive for TB culture. Among the 244 samples, 91 (37.2%) cases were smear positive, while 153 (62.7%) were smear negative. These findings highlight the importance of suggesting sputum culture in the diagnosis of tuberculosis in the high prevalence area of Quetta. Key words: Tuberculosis, misdiagnosis, sputum culture.
Highlights
Tuberculosis (TB) is an important health problem in the world with more than 8 million new cases and almost 2 million deaths each year (Dye et al, 2002; WHO, 2000)
Out of 2237 samples, 244 (10.9%) samples were preceded for MTB culture and smear microscopy sputum acid fast bacilli (AFB) and it was observed that the sputum AFB positive cases were 91 (37.29%) including 20 (21.97 %) positive samples from male patients while 71 (78.02%) were from female patients
It was found that among the 93 culture-positive samples, 82 were positive on sputum smear microscopy; 11 samples were negative for smear microscopy while nine samples were smear positive, but culture negative (Table 1)
Summary
Tuberculosis (TB) is an important health problem in the world with more than 8 million new cases and almost 2 million deaths each year (Dye et al, 2002; WHO, 2000). Smear-negative pulmonary tuberculosis (SNPT) is an increasing clinical and epidemiological problem in areas that are disease endemic. Diagnosis of SNPT is a difficult task, and in developing countries, the majority of these cases have been diagnosed only on the basis of clinical and chest radiographic findings (Ismail, 2004). The lack of accurate, rapid, and inexpensive tests for the diagnosis of pulmonary tuberculosis remains a foremost trouble in TB control, especially in high TB burden countries of Sub-Saharan Africa and South East Asia (Lucian et al, 2010). The majority of tuberculosis patients are diagnosed by a direct smear examination of sputum (WHO, 2007), how-ever, culture based diagnosis is more sensitive, and simultaneously allows for drug susceptibility (Moore et al, 2006).
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