Guinea-pig inoculation and culture for Mycobacterium tuberculosis in infertile women. A study of cost-effectiveness.
Endometrial biopsy (EB) specimens obtained from infertile women at Natalspruit Hospital are routinely subjected to histological examination, culture for tubercle bacilli and guinea-pig inoculation (GPI). A retrospective analysis of 103 EB specimens from Natalspruit Hospital and 255 specimens from private patients (in the Greater Johannesburg area) examined during January 1981 - August 1983 revealed a 1,96% overall incidence of endometrial tuberculosis (TB). The incidence of endometrial TB in infertile Black women attending Natalspruit Hospital during this period was 4,85%. Confirmed cases of endometrial TB yielded positive cultures in 57% of cases; GPIs were positive in 71% of cases and histological findings were positive in 42% of cases. Statistical comparison of culture and GPI was difficult because of the small number of cases involved. Cost analysis of culture and GPI suggested that culture of EB specimens as a routine screening procedure for infertile patients is more cost-effective and that GPI tests should be reserved for cases in which TB is highly probable. The literature on symptoms, pathology and diagnostic investigation of pelvic TB is briefly reviewed.
D000818:Animals; D001706:Biopsy; D003362:Cost-Benefit Analysis; D046508:Culture Techniques; D004717:Endometrium / Q000382:microbiology / Q000473:pathology; D005260:Female; D006168:Guinea Pigs; D006801:Humans; D007247:Infertility, Female / Q000382:microbiology*; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D012189:Retrospective Studies; D014384:Tuberculosis, Female Genital / Q000175:diagnosis* / Q000191:economics