Abstract
IntroductionTuberculosis is one of the most important infectious causes of death worldwide. Ziehl-Neelsen staining of sputum has high specificity in tuberculosis endemic countries, but modest sensitivity which varies among laboratories. This study was set up to investigate the diagnostic value of serum Adenosine deaminase in diagnosis of tuberculosis.MethodsIn a cross sectional and prospective study Serums of 200 patients of positive sputum smear, negative sputum smear, extra-pulmonary tuberculosis and bacterial community acquired pneumonia collected from March 2011 to May 2012 were evaluated. The data were analyzed using SPSS software and P-value of <0.05 was considered significant.ResultsA total of 200 subjects were included in the study designed in four groups. In cut-off value of ≥24 U/l for ADA in smear positive patients defined the sensitivity, specificity and positive predictive value 12%, 98% and 86% respectively. In smear negative patients defined the 6%, 98% and 75%, and in extra-pulmonary tuberculosis patients defined the sensitivity 14%, 98% and 88% respectively.ConclusionThis study indicated that measurement of serum ADA level do not have enough sensitivity to assist in the diagnoses of tuberculosis patients from other respiratory diseases and not evaluated perform well enough to replace sputum smear microscopy. Thus, this tests have little role in the diagnosis of pulmonary tuberculosis.
Highlights
Tuberculosis is one of the most important infectious causes of death worldwide
CAP). 22(44%) males and 28(56%) females with a mean age of 52.96 ± 22.14 were diagnosed as group I, 29(58%)males and 21(42%) females with a mean age of 59.10 ± 18.29 were diagnosed as group II, 23(46%) males, 27(54%) females with a mean age of 56.14 ± 20.69 were diagnosed as group III and 26(52%) males, 24(48%) females with a mean age of 58.94 ± 17.58 were diagnosed as group IV.The mean value for serum ADA level that determined in Sm+, Sm&minus, Ex-pul
In One-way Analysis of Variance (ANOVA) of mean differences of four groups the differences between group III (Ex-pul.) and group IV (CAP) was significant. (P-value =0.0115) (Table 1) The difference between the tuberculosis patient and non-tuberculosis patients with Mann-Whitney U test the differences between group I (Sm+) and group III with group IV (CAP) was significant. (P-value =0.0471 and p-value = 0.0001) (Table 2) In our study the relationship between age, gender, new case or relapse, type of extra-pulmonary tuberculosis and degree of positivity of sputum smear with serum level of Ada did not exist (p-value > 0.05)
Summary
Tuberculosis is one of the most important infectious causes of death worldwide. Ziehl-Neelsen staining of sputum has high specificity in tuberculosis endemic countries, but modest sensitivity which varies among laboratories. This study was set up to investigate the diagnostic value of serum Adenosine deaminase in diagnosis of tuberculosis. Conclusion: This study indicated that measurement of serum ADA level do not have enough sensitivity to assist in the diagnoses of tuberculosis patients from other respiratory diseases and not evaluated perform well enough to replace sputum smear microscopy. This tests have little role in the diagnosis of pulmonary tuberculosis. This study was set up to investigate the diagnostic value of serum Adenosin deaminase in diagnosis of tuberculosis because rapid and accurate diagnosis is an important element of TB treatment and control
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