Evaluation of in-house PCR for diagnosis of smear-negative pulmonary tuberculosis in Kampala, Uganda

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dc.contributor.authorNakiyingi, Lydia
dc.contributor.authorKateete, David P.
dc.contributor.authorOcama, Ponsiano
dc.contributor.authorWorodria, William
dc.contributor.authorSempa, Joseph B.
dc.contributor.authorAsiimwe, Benon B.
dc.contributor.authorKatabazi, Fred A.
dc.contributor.authorKatamba, Achilles
dc.contributor.authorHuang, Laurence
dc.contributor.authorJoloba, Moses L.
dc.contributor.authorMayanja-Kizza, Harriet
dc.date.accessioned2022-04-30T19:35:55Z
dc.date.available2022-04-30T19:35:55Z
dc.date.issued2012
dc.description.abstractNucleic acid amplification tests (NAATs) have offered hope for rapid diagnosis of tuberculosis (TB). However, their efficiency with smear-negative samples has not been widely studied in low income settings. Here, we evaluated in-house PCR assay for diagnosis of smear-negative TB using Lowenstein-Jensen (LJ) culture as the baseline test. Two hundred and five pulmonary TB (PTB) suspects with smear-negative sputum samples, admitted on a short stay emergency ward at Mulago Hospital in Kampala, Uganda, were enrolled. Two smear-negative sputum samples were obtained from each PTB suspect and processed simultaneously for identification of MTBC using in-house PCR and LJ culture. Results: Seventy two PTB suspects (35%, 72/205) were LJ culture positive while 128 (62.4%, 128/205) were PCR-positive. The sensitivity and specificity of in-house PCR for diagnosis of smear-negative PTB were 75% (95% CI 62.6-85.0) and 35.9% (95% CI 27.2-45.3), respectively. The positive and negative predictive values were 39% (95% CI 30.4-48.2) and 72.4% (95% CI 59.1-83.3), respectively, while the positive and negative likelihood ratios were 1.17 (95% CI 0.96-1.42) and 0.70 (95% CI 0.43-1.14), respectively. One hundred and seventeen LJ culturenegative suspects (75 PCR-positive and 42 PCR-negative) were enrolled for follow-up at 2 months. Of the PCR-positive suspects, 45 (60%, 45/75) were still alive, of whom 29 (64.4%, 29/45) returned for the follow-up visit; 15 (20%, 15/75) suspects died while another 15 (20%, 15/75) were lost to follow-up. Of the 42 PCR-negative suspects, 22 (52.4%, 22/42) were still alive, of whom 16 (72.7%, 16/22) returned for follow-up; 11 (26.2%, 11/42) died while nine (21.4%, 9/42) were lost to follow-up. Overall, more PCR-positive suspects were diagnosed with PTB during follow-up visits but the difference was not statistically significant (27.6%, 8/29 vs. 25%, 4/16, p = 0.9239). Furthermore, mortality was higher for the PCR-negative suspects but the difference was also not statistically significant (26.2% vs. 20% p = 0.7094). Conclusion: In-house PCR correlates poorly with LJ culture for diagnosis of smear-negative PTB. Therefore, in-house PCR may not be adopted as an alternative to LJ culture.en_US
dc.identifier.citationNakiyingi et al.: Evaluation of in-house PCR for diagnosis of smear-negative pulmonary tuberculosis in Kampala, Uganda. BMC Research Notes 2012 5:487. doi:10.1186/1756-0500-5-487en_US
dc.identifier.other10.1186/1756-0500-5-487
dc.identifier.urihttps://nru.uncst.go.ug/handle/123456789/3068
dc.language.isoenen_US
dc.publisherBMC Research Notesen_US
dc.subjectPulmonary tuberculosisen_US
dc.subjectSmear-negative TBen_US
dc.subjectSmear-negative TBen_US
dc.subjectHIV-infecteden_US
dc.subjectHIV-TB co-infectionen_US
dc.subjectCD4 cell countsen_US
dc.subjectNucleic acid amplification testsen_US
dc.subjectIn-house PCRen_US
dc.subjectLowenstein-Jensen cultureen_US
dc.subjectSensitivity, Specificityen_US
dc.subjectResource limited settingsen_US
dc.titleEvaluation of in-house PCR for diagnosis of smear-negative pulmonary tuberculosis in Kampala, Ugandaen_US
dc.typeArticleen_US
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