THE MICROBIOLOGICAL DIAGNOSIS OF TUBERCULOSIS IN A RESOURCE LIMITED SETTING: IS ACID-FAST BACILLI MICROSCOPY ALONE SUFFICIENT?

Authors

M.O ODUBANJO AND H.O DADA-ADEGBOLA

Correspondents

DR. M.O ODUBANJO
Department of Pathology
University College Hospital,
Ibadan, Nigeria.

Affiliation of Authors

DEPARTMENT OF PATHOLOGY, UNIVERSITY COLLEGE HOSPITAL IBADAN
DEPARTMENT OF MEDICAL MICROBIOLOGY AND PARASITOLOGY, UNIVERSITY COLLEGE HOSPITAL, IBADAN.
ABSTRACT 
The objective of this study is to audit the processes for the microbiological diagnosis of tuberculosis (TB) in our resource – limited setting. A total of 694 specimens were received from 33 patients. 129 (38.7%) of thewse patients were postive for TB. 78 (605%) were positive on AFB microscopy alone, 13 (10.0%) on culture alone and 38 (29.5%) on both culture,38 of these (74.5%) had growth on Lowensen-Jensen culture medium alone, 11 (19.6%) on pyretic Acid Enhanced Medium (PAEM) and 3 (5.9%) on both culture media. AFB microscopy showed a diagnotic specificity of 71.6% and sensitivity of 74.5%. M. Bovis appears to be prevalent and we suggest the need for speciation. If AFB microscopy is to be routinely used alone, without confirmation by culture, then the overriding need is for quality to be fully assured in its use.
Keywords: Mycobacteria, Tuberculosis, Accuracy, AFB microscopy, Culture
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