Open AccessLaboratory Investigations on the Diagnosis of Tuberculosis in the Malnourished Tribal Population of Melghat, India
Author(s) -
Rajpal S. Kashyap,
Amit R. Nayak,
Hari M. Gaherwar,
Shraddha S. Bhullar,
Aliabbas A. Husain,
Seema D. Shekhawat,
Ruchika Jain,
Sonali S. Gaikwad,
Ashish Satav,
Hemant J. Purohit,
Girdhar M. Taori,
Hatim F. Daginawala
Publication year - 2013
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0074652
Subject(s) - tuberculosis , medicine , population , environmental health , pathology
Background Malnutrition is a major risk factor for the development of tuberculosis (TB). In India, Melghat is among the tribal regions which consist of highest number of malnutrition cases. Because of the paucity of TB data from these malnourished areas there is an urgent need for the development and evaluation of improved TB diagnostic tests. In the present study, three in house developed diagnostic tests namely TB-Ag(antigen) ELISA, Adenosine deaminase (ADA) estimation and IS 6110 polymerase chain reaction (PCR) assay were investigated for the detection of Mycobacterium tuberculosis ( M. tb. ) infection. Methods For investigation, blood samples were collected from 128 study subjects from six villages of Melghat tribal area and evaluated using three in house developed assays, namely TB-Ag ELISA, ADA estimation and IS 6110 PCR. Results The TB-Ag ELISA method yielded 83% sensitivity and 94% specificity. The ADA and PCR assay gave a sensitivity of 61% and 49% and specificity of 62% and 98% respectively. A considerable good agreement of 82.81% (k=0.472) between TB-Ag ELISA and PCR was observed. The overall sensitivity of TB-Ag ELISA was significantly higher (p<0.05) than the ADA and PCR while PCR yielded highest specificity among all the three evaluated tests. Conclusions We concluded that the routine use of TB-Ag ELISA can be useful for screening of suspected TB patients in the malnourished population where sophisticated laboratory set up is difficult.