Objective:To investigate the application of Ziehl-Neelsen(Z-N) and fluorescent microscopy in detection of acid fast bacilli(AFB).Methods:Duplicate smears were prepared from 260 sputum samples and stained with Z-N and ...Objective:To investigate the application of Ziehl-Neelsen(Z-N) and fluorescent microscopy in detection of acid fast bacilli(AFB).Methods:Duplicate smears were prepared from 260 sputum samples and stained with Z-N and fluorescent staining(FS) methods.The efficiency of both methods in primary diagnosis of tuberculosis were evaluated.Results:The smears were positive for AFB in 15(5.77%) samples by Z-N staining method and in 16(6.15%) samples by FS method.The sensitivity and specificity of Z-N staining method against FS method were 93.75% and 100%respectively.Conclusions:Though lesser cost-effective than Z-N,FS method is a more sensitive and better case finding tool in detection of AFB.展开更多
目的探讨实时荧光定量PCR(qPCR)在结核病理诊断中的应用价值。方法回顾性分析1323例疑似结核病的石蜡包埋组织qPCR结果,并与临床诊断结果、抗酸染色结果进行对比分析。结果1323例病例中1073例有明确的诊断结果,其中结核阳性率为68.22%(7...目的探讨实时荧光定量PCR(qPCR)在结核病理诊断中的应用价值。方法回顾性分析1323例疑似结核病的石蜡包埋组织qPCR结果,并与临床诊断结果、抗酸染色结果进行对比分析。结果1323例病例中1073例有明确的诊断结果,其中结核阳性率为68.22%(732/1073)。1073例病例中,qPCR阳性率为45.39%、敏感性为0.663、特异性为0.994,肺、胸膜、骨、淋巴结、肠中qPCR敏感性分别为0.706、0.676、0.437、0.678、0.625,特异性分别为0.993、1.000、1.000、1.000、1.000,手术组织阳性率和敏感性分别为48.42%、0.692,均高于活检组织,且差异有统计学意义(P<0.05)。755例同时具有qPCR结果和抗酸染色结果的病例中,qPCR与抗酸染色法符合率75.36%(95%CI 72.17~78.30),qPCR阳性率(43.44%,328/755)高于抗酸染色的阳性率(21.5%,162/755)(P<0.05),qPCR的AUC(95%CI)=0.837(0.817~0.859)高于抗酸染色AUC(95%CI)=0.656(0.634~0.678)(P<0.05),敏感性高于抗酸染色(0.677 vs 0.327)(P<0.05)。结论qPCR在结核病的病理诊断中具有良好的应用价值,联合抗酸染色可以更准确地进行鉴别诊断。展开更多
Background: In Gabon, the epidemiology of tuberculosis has been considerably reshaped by the AIDS virus. It is in this context that the present study was conducted to assess the prevalence of pulmonary tuberculosis an...Background: In Gabon, the epidemiology of tuberculosis has been considerably reshaped by the AIDS virus. It is in this context that the present study was conducted to assess the prevalence of pulmonary tuberculosis and associated factors among patients at the Amissa Bongo Regional Hospital in Franceville, Gabon. Patients and Methods: This prospective, cross-sectional study was conducted in the biomedical analysis laboratory of the Amissa Bongo Regional University Hospital in Franceville from 19 June 2021 to 22 January 2022. After agreeing to take part in the study, participants were asked to fill in a questionnaire to collect their socio-demographic data and habits. Clinical signs were also observed. Sputum and gastric fluid samples were collected and examined using the Xpert MTB/RIF test and BAAR smear microscopy. Data were analysed using R software version 3.6.1. The results of the univariate and multivariate analyses were considered significant for p ≤ 0.05. Results: A total of 309 patients were included in this study, 50.81% (n = 157) men and 49.19% (n = 152) women. Of these, 98 had a positive diagnosis of pulmonary tuberculosis, giving an overall prevalence rate of 31.72%. There were 40 women or 40.82% (95% CI: [0.30 - 0.51]) and 58 men or 59.18% (95% CI: [0.48 - 0.69]). A univariate analysis of the prevalence of tuberculosis according to risk factors and clinical signs indicated a certain association between certain variables. However, an in-depth multivariate logistic regression analysis of this prevalence, according to the risk factors and clinical signs observed in the patients in the study, indicated that the age group 15 and 49 years (Adjusted OR = 47.77;95% CI: [4.4;519.7] p = 0.001*), fever (Adjusted OR = 4.83;95% CI: [1.16, 20.12] p = 0.031*), alcohol consumption (Adjusted OR = 12.2;95% CI: 12.2 [2.5;5.9] p = 0. 002*), smoking (Adjusted OR = 9.83;95% CI: [1.78;54.24] p = 0.037), HIV infection (Adjusted OR = 4.63;95% CI: [1.25;17.1] p = 0.022), cough (Adjusted OR = 4.31;95% CI: [1.21, 15.4] p = 0. 025*), chest pain (Adjusted OR = 103.6;95% CI: [19.4;55.2] p = 0.000), night sweating cough (Adjusted OR = 10.84;95% CI: [3.18;36.98] p = 0.000*) were significant risk factors for pulmonary tuberculosis. Conclusion: The results of the present study showed that the prevalence of pulmonary tuberculosis was greatest among males in Franceville and the surrounding area. The 15 - 49 age group, fever, alcohol consumption, smoking, HIV infection, chest pain, night sweats and cough were significant risk factors for pulmonary tuberculosis. Consequently, screening for tuberculosis in HIV-positive patients, public awareness and community mobilisation should be encouraged.展开更多
文摘Objective:To investigate the application of Ziehl-Neelsen(Z-N) and fluorescent microscopy in detection of acid fast bacilli(AFB).Methods:Duplicate smears were prepared from 260 sputum samples and stained with Z-N and fluorescent staining(FS) methods.The efficiency of both methods in primary diagnosis of tuberculosis were evaluated.Results:The smears were positive for AFB in 15(5.77%) samples by Z-N staining method and in 16(6.15%) samples by FS method.The sensitivity and specificity of Z-N staining method against FS method were 93.75% and 100%respectively.Conclusions:Though lesser cost-effective than Z-N,FS method is a more sensitive and better case finding tool in detection of AFB.
文摘目的探讨实时荧光定量PCR(qPCR)在结核病理诊断中的应用价值。方法回顾性分析1323例疑似结核病的石蜡包埋组织qPCR结果,并与临床诊断结果、抗酸染色结果进行对比分析。结果1323例病例中1073例有明确的诊断结果,其中结核阳性率为68.22%(732/1073)。1073例病例中,qPCR阳性率为45.39%、敏感性为0.663、特异性为0.994,肺、胸膜、骨、淋巴结、肠中qPCR敏感性分别为0.706、0.676、0.437、0.678、0.625,特异性分别为0.993、1.000、1.000、1.000、1.000,手术组织阳性率和敏感性分别为48.42%、0.692,均高于活检组织,且差异有统计学意义(P<0.05)。755例同时具有qPCR结果和抗酸染色结果的病例中,qPCR与抗酸染色法符合率75.36%(95%CI 72.17~78.30),qPCR阳性率(43.44%,328/755)高于抗酸染色的阳性率(21.5%,162/755)(P<0.05),qPCR的AUC(95%CI)=0.837(0.817~0.859)高于抗酸染色AUC(95%CI)=0.656(0.634~0.678)(P<0.05),敏感性高于抗酸染色(0.677 vs 0.327)(P<0.05)。结论qPCR在结核病的病理诊断中具有良好的应用价值,联合抗酸染色可以更准确地进行鉴别诊断。
文摘Background: In Gabon, the epidemiology of tuberculosis has been considerably reshaped by the AIDS virus. It is in this context that the present study was conducted to assess the prevalence of pulmonary tuberculosis and associated factors among patients at the Amissa Bongo Regional Hospital in Franceville, Gabon. Patients and Methods: This prospective, cross-sectional study was conducted in the biomedical analysis laboratory of the Amissa Bongo Regional University Hospital in Franceville from 19 June 2021 to 22 January 2022. After agreeing to take part in the study, participants were asked to fill in a questionnaire to collect their socio-demographic data and habits. Clinical signs were also observed. Sputum and gastric fluid samples were collected and examined using the Xpert MTB/RIF test and BAAR smear microscopy. Data were analysed using R software version 3.6.1. The results of the univariate and multivariate analyses were considered significant for p ≤ 0.05. Results: A total of 309 patients were included in this study, 50.81% (n = 157) men and 49.19% (n = 152) women. Of these, 98 had a positive diagnosis of pulmonary tuberculosis, giving an overall prevalence rate of 31.72%. There were 40 women or 40.82% (95% CI: [0.30 - 0.51]) and 58 men or 59.18% (95% CI: [0.48 - 0.69]). A univariate analysis of the prevalence of tuberculosis according to risk factors and clinical signs indicated a certain association between certain variables. However, an in-depth multivariate logistic regression analysis of this prevalence, according to the risk factors and clinical signs observed in the patients in the study, indicated that the age group 15 and 49 years (Adjusted OR = 47.77;95% CI: [4.4;519.7] p = 0.001*), fever (Adjusted OR = 4.83;95% CI: [1.16, 20.12] p = 0.031*), alcohol consumption (Adjusted OR = 12.2;95% CI: 12.2 [2.5;5.9] p = 0. 002*), smoking (Adjusted OR = 9.83;95% CI: [1.78;54.24] p = 0.037), HIV infection (Adjusted OR = 4.63;95% CI: [1.25;17.1] p = 0.022), cough (Adjusted OR = 4.31;95% CI: [1.21, 15.4] p = 0. 025*), chest pain (Adjusted OR = 103.6;95% CI: [19.4;55.2] p = 0.000), night sweating cough (Adjusted OR = 10.84;95% CI: [3.18;36.98] p = 0.000*) were significant risk factors for pulmonary tuberculosis. Conclusion: The results of the present study showed that the prevalence of pulmonary tuberculosis was greatest among males in Franceville and the surrounding area. The 15 - 49 age group, fever, alcohol consumption, smoking, HIV infection, chest pain, night sweats and cough were significant risk factors for pulmonary tuberculosis. Consequently, screening for tuberculosis in HIV-positive patients, public awareness and community mobilisation should be encouraged.
