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Glutaraldehyde test for the rapid diagnosis of pulmonary and extra-pulmonary tuberculosis in an area with high tuberculosis incidence
Ahmed, Ben Hadj Hassine; Manel, Marzouk; Mohamed, Dhaou & Jalel, Boukadida
Abstract
BACKGROUND Tuberculosis (TB) remains one of the leading causes of morbidity and mortality worldwide. The primary method
for controlling TB is the rapid and accurate identification of infected individuals. Immune response exploitation represents one of
the main methods used for early TB diagnosis; however, few studies have reported that whole blood originating from TB-infected
patients gels faster in the presence of aldehyde than blood originating from healthy subjects, which is the focus of the current study.
OBJECTIVES The study objectives are to determine the diagnostic value of a glutaraldehyde test (GT) in pulmonary tuberculosis
(PTB) and extra-pulmonary tuberculosis (EPTB) and to assess its performance compared with light-emitting diode fluorescence
microscopy (LED-FM).
MATERIALS AND METHODS This study included 272 specimens (176 suspected PTB specimens and 96 suspected EPTB
specimens). Of the 272 patients, 98 patients had TB infection confirmed by culture (64 PTB cases and 34 EPTB cases), and 174
patients had no TB infection. The gold standard technique (culture) was used as reference to verify the GT’s performance.
RESULTS The GT showed a high sensitivity (96.9%) and specificity (82.1%) for PTB with a good positive predictive value (PPV =
75.6%) and negative predictive value (NPV = 97.9%). For EPTB, the GT showed a sensitivity of 91.2% and a specificity of 77.4%,
with PPV = 68.9% and NPV = 94.1%. LED-FM had lower sensitivities for PTB (65.6%) and EPTB (42.1%) and an excellent
specificity of 100%, with PPV = 100% and NPV = 100%.
CONCLUSION We concluded that GT is rapid, easy, simple and cost-effective and does not require qualified personnel with
a specific background or sophisticated equipment like molecular biology or mycobacterium-specific genotyping techniques.
These qualities make the GT attractive for use in low- and high-income countries in addition to other conventional methods,
particularly culture, which continues to be the gold standard.
Keywords
diagnosis; gelification time; glutaraldehyde test; light-emitting diode; tuberculosis
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