الفهرس | Only 14 pages are availabe for public view |
Abstract SUMMARY T his study was conducted to evaluate the performance of quantiferon test in 100 of suspected pulmonary tuberculosis patients in Abassia chest hospital and a trial to sit a cut-off point of quantiferon test if possible. Exclusion criteria: Immunocompromised e.g. HIV, steroid therapy, diapetics, chronic liver and kidney diseases….etc. Inclusion criteria: Age ≥18 years old. Both gender. Patient who presented with symptoms and signs suspected pulmonary tuberculosis. Every case subjected to: History taking (present, past and family). Examination (general, local). Chest X- ray (postro-anterior view). Sputum for acid fast bacilli (by Ziehl neelsen stain) Quantiferon test Results showed: Age of our patients ranged from 18-70 years and with mean ± SD (35.68±15.37), they were 40 females (40%) and 60 males (60%). The chief symptoms were the toxic symptoms in the form of fever (58) 58%, loss of weight (43) 43%, loss of appetite (35) 35%, and night sweating (31) 31%, in addition to productive cough (56) 56%, haemoptysis (13) 13% and dyspnea (36) 36%. The main chest X-ray findings were consolidation (47) 47%, increased broncho-vascular markings (12) 12%, obliteration of costophrenic angle with homogenous opacity rising to axilla (32) 32% and single cavitary lesion (15) 15%. Sputum for acid fast bacilli results among the studied patients showed that (48) 48% were negative, (13) 13% positive, and (39) 39% did not make the test due to no sputum sample was given. Quantiferon test results were (54) 54% negative and (46) 46% positive. Tuberculin skin test was done only for 17 cases of the studied group with (7) 41.2% negative and (10) 58.8% positive. Final diagnosis was pneumonia (38) 38%, tuberculosis (27 new pulmonary cases, 5 pulmonary relapse and one case intestinal TB) 33%, pleural effusion (19) 19%, abscess (17) 17%, bronchitis (15) 15%. There was no statistically significant relation found between TB AG-nil and quantiferon test results and demographic data of the studied patients. There was statistically significant higher incidence of sweating, fever, loss of weight, loss of appetite and productive cough in patients with increase in the level of TB AG-nil and positive quantiferon test results. Increase in the incidence of multiple cavitary lesions in patients with increase in the level of TB AG-nil and positive quantiferon. Significant increase in the incidence of positive sputum for acid fast bacilli patients with increase in the level of TB AG-nil and positive quantiferon group. Significant increase in the incidence of positive tuberculin test results in patients with increase in the level of TB AG-nil and positive quantiferon. There was highly statistically significant increase in the level of nil, TB AG and TB AG-nil in patients with positive quantiferon results. The ROC curve shows that the best cut off point to predict patients with positive quantiferon test was found > 0.33 with sensitivity 100% and specificity 93.55% and area under curve (AUC) of 96.8%. |