title: Concentration of fine needle aspirates similar to molecular method improves sensitivity of the diagnosis of tuberculous lymphadenitis in Addis Ababa, Ethiopia.
abstract: Tuberculous lymphadenitis (TBLN) diagnosis has been a true challenge solely by clinical evidence in developing countries, due to limited the diagnostic facility on hand. However, the availability and affordability of available diagnostic tools in resource-limited settings like Ethiopia necessitates the quest for other techniques with added value over direct Z-N microscopy. Therefore, we aimed at to assess whether the concentration of lymph node aspirate similarly improves the detection rate of tuberculous lymphadenitis or not.
  
  
  
  A cross-sectional study design was conducted on 132 individual subjects presumptive for tuberculous lymphadenitis from February to October 2013 in Addis Ababa, Ethiopia. Fine needle aspirate (FNA) samples were collected from the cases and cultured on Löwenstein-Jensen (LJ) slants. Identification of species and strains of mycobacteria was made by region of difference (RD) based polymerase chain reaction (PCR). Data entry and statistical analyses were performed by SPSS version 20. The confidence level of 95% was used for statistical significance.
  
  
  
  A total of 132 study subjects were included in our study. Of these 56.1% (74/132) were positive for M. tuberculosis on culture. The detection rate of direct smear microscopy and the concentration method were 29.5 and 65.2% respectively. The sensitivity of direct smear microscopy was 43.2%, for concentrated smear microscopy 94.5%, for PCR 93.2% and for cytomorphology 95.4%. The level of agreement of concentrated ZN smear microscopy was 0.62 which was very similar with kappa of 0.58 of molecular (PCR) technique. AFB positivity by the concentration method and molecular method was increased in caseous aspirates as compared to purulent and hemorrhagic aspirates though it was not statistically significant (p-value = 0.18) and (p = 0.62) respectively.
  
  
  
  The concentration of FNA (Fine Needle Aspirate) aspirates for acid-fast smear microscopy similarly improves the sensitivity of acid fast bacilli in diagnosing of TBLN.
authors.affiliation: Department of Medical Laboratory Sciences, College of Medical and Health Sciences, Wollega University, PO Box 395, Nekemte, Ethiopia. olifangdr@gmail.com.|Department of Microbiology, Immunology and Parasitology, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia. olifangdr@gmail.com.
authors.forename: Olifan
authors.initials: O
authors.lastname: Zewdie
authors.affiliation: Department of Microbiology, Immunology and Parasitology, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia.
authors.forename: Tamrat
authors.initials: T
authors.lastname: Abebe
authors.affiliation: Department of Microbiology, Immunology and Parasitology, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia.
authors.forename: Adane
authors.initials: A
authors.lastname: Mihret
authors.affiliation: School of Veterinary Medicine, Wollega University, Nekemte, Ethiopia.
authors.forename: Eyob
authors.initials: E
authors.lastname: Hirpa
authors.affiliation: Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia.
authors.forename: Gobena
authors.initials: G
authors.lastname: Ameni
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D044963:Biopsy, Fine-Needle / Q000379:methods*; D003430:Cross-Sectional Studies; D004269:DNA, Bacterial / Q000032:analysis*; D003906:Developing Countries; D005002:Ethiopia; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000382:microbiology* / Q000473:pathology; D008297:Male; D008853:Microscopy; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000235:genetics / Q000302:isolation & purification*; D016133:Polymerase Chain Reaction / Q000379:methods; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014388:Tuberculosis, Lymph Node / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology; D055815:Young Adult
chemical_list: D004269:DNA, Bacterial
keywords: Addis Ababa; FNA; PCR; Smear concentration; TBLN