Evaluation of modified bleach technique for the detection of acid fast bacilli in lymph node aspirate at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia
Background: Tuberculous Lymphadenitis (TBLN) is the commonest form of extrapulmonary tuberculosis. Definitive diagnosis of TBLN is difficult due to the low efficacy of the routine diagnostic techniques as compared to culture. Objective: To determine whether prior bleach concentration can improve the...
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2022-08-01
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| Series: | Journal of Clinical Tuberculosis and Other Mycobacterial Diseases |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S240557942200033X |
| _version_ | 1818513581751140352 |
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| author | Firehiwot Mulugeta Moges Tiruneh Bewketu Abebe Gashaw Yitayew Zimam Ayehubizu Muluwork Getahun Aschalew Gelaw |
| author_facet | Firehiwot Mulugeta Moges Tiruneh Bewketu Abebe Gashaw Yitayew Zimam Ayehubizu Muluwork Getahun Aschalew Gelaw |
| author_sort | Firehiwot Mulugeta |
| collection | DOAJ |
| description | Background: Tuberculous Lymphadenitis (TBLN) is the commonest form of extrapulmonary tuberculosis. Definitive diagnosis of TBLN is difficult due to the low efficacy of the routine diagnostic techniques as compared to culture. Objective: To determine whether prior bleach concentration can improve the detection of acid-fast bacilli when compared with conventional Ziehl-Neelsen (ZN) staining by using culture as the gold standard. Methods: Cross-sectional study was conducted from March 01, 2015 to May 30, 2015. The study subjects were clinically suspected TBLN patients. Fine needle aspiration (FNA) was performed. Two different smears were prepared directly from the first needle pass for cytology and ZN staining. The remaining aspirate was used for the modified bleach concentration. The second needle pass aspirate was transferred into a sterile container containing sterile normal saline. The sediment was inoculated on the Lowenstein Jensen (LJ) medium. Measurement parameters for reliability and validity were used to analyze the results. Result: A total of 93 participants were included in the study. Fifty-six out of the 93 (60.2 %) cases were positive for mycobacterium tuberculosis complex on LJ culture. The detection rates of direct ZN staining and modified bleach method were 20.4 % and 44.1 %, respectively. 73.1 % of the cases showed cytomorphological features consistent with TBLN by cytologic examination. The sensitivities of direct ZN staining and modified bleach method and cytomorphology were 32.0 %, 67.8 %, and 92.8 %, respectively. Conclusion: Implementation of bleach concentration increases the detection rate of AFB over the direct ZN method. The bleach method can also be easily performed and provide a safe working environment by reducing infections. |
| first_indexed | 2024-12-11T00:03:25Z |
| format | Article |
| id | doaj.art-d61d7b5cc8944323a6998b407983a868 |
| institution | Directory Open Access Journal |
| issn | 2405-5794 |
| language | English |
| last_indexed | 2024-12-11T00:03:25Z |
| publishDate | 2022-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Clinical Tuberculosis and Other Mycobacterial Diseases |
| spelling | doaj.art-d61d7b5cc8944323a6998b407983a8682022-12-22T01:28:24ZengElsevierJournal of Clinical Tuberculosis and Other Mycobacterial Diseases2405-57942022-08-0128100328Evaluation of modified bleach technique for the detection of acid fast bacilli in lymph node aspirate at the University of Gondar Comprehensive Specialized Hospital, Northwest EthiopiaFirehiwot Mulugeta0Moges Tiruneh1Bewketu Abebe2Gashaw Yitayew3Zimam Ayehubizu4Muluwork Getahun5Aschalew Gelaw6University of Gondar, School of Biomedical and Laboratory Sciences, College of Medicine and Health Science, Department of Medical Microbiology, EthiopiaUniversity of Gondar, School of Biomedical and Laboratory Sciences, College of Medicine and Health Science, Department of Medical Microbiology, EthiopiaUniversity of Gondar, School of Biomedical and Laboratory Sciences, College of Medicine and Health Science, Department of Pathology University, EthiopiaAmhara Public Health Institute, Bahir Dar, EthiopiaBahir Dar University, College of Health Science, Department of Medical Laboratory Sciences, EthiopiaEthiopian Public Health Institute, Tuberculosis Laboratory, Addis Ababa, EthiopiaUniversity of Gondar, School of Biomedical and Laboratory Sciences, College of Medicine and Health Science, Department of Medical Microbiology, Ethiopia; Corresponding author.Background: Tuberculous Lymphadenitis (TBLN) is the commonest form of extrapulmonary tuberculosis. Definitive diagnosis of TBLN is difficult due to the low efficacy of the routine diagnostic techniques as compared to culture. Objective: To determine whether prior bleach concentration can improve the detection of acid-fast bacilli when compared with conventional Ziehl-Neelsen (ZN) staining by using culture as the gold standard. Methods: Cross-sectional study was conducted from March 01, 2015 to May 30, 2015. The study subjects were clinically suspected TBLN patients. Fine needle aspiration (FNA) was performed. Two different smears were prepared directly from the first needle pass for cytology and ZN staining. The remaining aspirate was used for the modified bleach concentration. The second needle pass aspirate was transferred into a sterile container containing sterile normal saline. The sediment was inoculated on the Lowenstein Jensen (LJ) medium. Measurement parameters for reliability and validity were used to analyze the results. Result: A total of 93 participants were included in the study. Fifty-six out of the 93 (60.2 %) cases were positive for mycobacterium tuberculosis complex on LJ culture. The detection rates of direct ZN staining and modified bleach method were 20.4 % and 44.1 %, respectively. 73.1 % of the cases showed cytomorphological features consistent with TBLN by cytologic examination. The sensitivities of direct ZN staining and modified bleach method and cytomorphology were 32.0 %, 67.8 %, and 92.8 %, respectively. Conclusion: Implementation of bleach concentration increases the detection rate of AFB over the direct ZN method. The bleach method can also be easily performed and provide a safe working environment by reducing infections.http://www.sciencedirect.com/science/article/pii/S240557942200033XExtrapulmonary tuberculosisLymph node aspirateModified bleach technique |
| spellingShingle | Firehiwot Mulugeta Moges Tiruneh Bewketu Abebe Gashaw Yitayew Zimam Ayehubizu Muluwork Getahun Aschalew Gelaw Evaluation of modified bleach technique for the detection of acid fast bacilli in lymph node aspirate at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia Journal of Clinical Tuberculosis and Other Mycobacterial Diseases Extrapulmonary tuberculosis Lymph node aspirate Modified bleach technique |
| title | Evaluation of modified bleach technique for the detection of acid fast bacilli in lymph node aspirate at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia |
| title_full | Evaluation of modified bleach technique for the detection of acid fast bacilli in lymph node aspirate at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia |
| title_fullStr | Evaluation of modified bleach technique for the detection of acid fast bacilli in lymph node aspirate at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia |
| title_full_unstemmed | Evaluation of modified bleach technique for the detection of acid fast bacilli in lymph node aspirate at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia |
| title_short | Evaluation of modified bleach technique for the detection of acid fast bacilli in lymph node aspirate at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia |
| title_sort | evaluation of modified bleach technique for the detection of acid fast bacilli in lymph node aspirate at the university of gondar comprehensive specialized hospital northwest ethiopia |
| topic | Extrapulmonary tuberculosis Lymph node aspirate Modified bleach technique |
| url | http://www.sciencedirect.com/science/article/pii/S240557942200033X |
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