BASILIUS B KILOWOKO ST BENEDICTS NDANDA REFERRAL HOSPITAL
BASILIUS B KILOWOKO ST. BENEDICT’S NDANDA REFERRAL HOSPITAL MTWARA -TANZANIA
Comparing the Yield of Front – Loading Microscopy with Conventional Sputum Microscopy Examination for the Diagnosis of Tuberculosis at St. Benedict’s Ndanda Referral Hospital Kilowoko. B 1, Millanzi. O. C 1, Temu. S. R 1, Kimaro. G. D 2, Ngadaya. E 2, Sandi E 2, Shemtandulo R 2, and Mfinanga G. S 1 Affiliation: 1 St. Benedict’s Ndanda Referral Hospital Laboratory. 2 National Institute for Medical Research, Muhimbili Medical Research Centre
Introduction Individuals suspected of having TB are required to submit two sputum samples (spot and morning samples) for TB diagnosis. Due to different reasons, pre-treatment defaulting has been reported. Presumptive TB patient may submit only one sputum sample (spot sample) or may submit two sputum samples but don’t come back to laboratory to pick their results.
Intro…. . Some of the defaulters are smear positive posing two dangers - spreading disease to the community - defaulter suffers TB related morbidity or motality Experience show between April to December 2014, a total of 689 TB suspects were registered at Ndanda hospital. - 51% (351/689) did not submit their 2 nd sample
Intro…. These 351 presumptive TB patients were lost from care before their diagnosis pathway was completed and hence their TB status could not be established These pre-treatment loses from care could be avoided if diagnosis pathway could be completed on the same day and managed accordingly
Intro…. This analysis aimed at introducing and examining the yield of a front – loading (submitting two spot sputum on the same day) and compare it with the yield of the conventional approach (spot-morning sputum submission).
Methodology This x-sectional study enrolled all presumptive TB patients presented at the facility between 10 th Nov 2015 and 4 th July 2016. Each consented study participant was asked to submit: - Spot and morning sputum samples - and additional spot sputum (Xspot) 1 hr after the 1 st spot sputum sample Samples were processed using both ZN and Gene. Xpert.
Results A total of 473 presumptive TB patients were enrolled in the study All participants submitted spot 1 sputum samples - 470 (99. 4%) submitted Xspot sputum samples - 374 (79. 1%) submitted morning sputum sample 90/473 (19%) of the participants who submitted spot 1 sputum samples tested ZN positive
Results…. Of the 3 (0. 6%)participants who did not submit Xspot sputum sample 1 was ZN +ve on spot 1 Among 470 participants who submitted Xspot samples 89(18. 8%) tested ZN +ve on both spot and Xspot 74 of 374 (19. 8%)of those who submitted morning sputum samples tested ZN +ve and their results were similar to those of spot 1 and Xspot.
Results…. Gene. Xpert tests were performed to 180 (38%) spot 1 samples - 42(23. 3%) tested +ve on Gene. Xprt and were also ZN+ve on spot 1 and Xspot. Combination of ZN results for spot 1 and Xspot yields similar ZN results to those of combinined ZN results for spot 1 and morning samples.
Conclusion and Recommendation
Frontloading approach (spot + Xspot) yields similar ZN results to conventional approach (spot + morning). NTLP may consider adaptation of frontloading approach to curb challenges associated with pre-treatment loses from care
Acknowledgement - EAPHLNP - SBNRH
End Asanteni Sana!
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