COMPARISON OF POLYMERASE CHAIN REACTION WITH CONVENTIONAL METHOD IN THE LABORATORY DIAGNOSIS OF PULMONARY TUBERCULOSIS IN JOS, PLATEAU STATE, NIGERIA

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COMPARISON OF POLYMERASE CHAIN REACTION WITH CONVENTIONAL METHOD IN THE LABORATORY DIAGNOSIS OF PULMONARY TUBERCULOSIS IN JOS, PLATEAU STATE, NIGERIA

Abstract

The laboratories in resource poor settings commonly use smear microscopy for the diag
nosis of pulmonary tuberculosis (PTB), it is rapid, cheap and easy to perform. Cultural methods
are slow and insensitive enough in multibacillary PTB and the difficulties are greatly magnified in
the case of paucibacillary pulmonary or non-pulmonary disease. The use of Polymerase Chain
Reaction (PCR) in the diagnosis of tuberculosis (TB) has been of overwhelming advantages for
effective pulmonary TB case detections.
A total of 103 patients sputum samples were collected at Jos University Teaching Hospital
(JUTH) TB reference laboratory and analysed using smear microscopy, PCR and culture for the
diagnosis of pulmonary tuberculosis (PTB), 13 (12.6%) of these samples were from HIV positive
individuals and 14 (13.6%) were from individuals with unknown HIV status.
A total of 13 (12.6%) sputa were positive for TB by microscopy whereas PCR detected 24
(23.0%) cases and cultural method detected 20 (19.4%) cases. PCR diagnosed 11 cases (45.8%)
missed by smear microscopy and 4 cases (16%) missed by culture. The sensitivity of PCR was
found to be 100% whereas smear microscopy has sensitivity of 54.2%. The specificity of both
PCR and smear microscopy is 100%. PCR have higher negative predictive value (100%) than
microscopy (87.8%) with both having positive predictive value of 100%. The prevalence of TB
for smear microscopy, PCR and culture was found to be 12.6%, 23.3% and 19.1% respectively

(mean 18.3%). The results of PCR, microscopy and culture were ready within 1.2 days, 1.7 days,
50.6 days respectively. PCR played a very great role in detection of cases of pulmonary tubercu
losis missed by smear microscopy. PCR reported a higher frequency of pulmonary tuberculosis
than smear microscopy and culture; therefore, it is a better laboratory procedure for early detection
and assessment of true burden of the disease in our environment.

COMPARISON OF POLYMERASE CHAIN REACTION WITH CONVENTIONAL METHOD IN THE LABORATORY DIAGNOSIS OF PULMONARY TUBERCULOSIS IN JOS, PLATEAU STATE, NIGERIA

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