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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
immunology and microbiology
Is tuberculous lymphadenitis over-diagnosed in Ethiopia? Comparative performance of diagnostic tests for mycobacterial lymphadenitis in a high-burden country
Scandinavian Journal of Infectious Diseases, Volume 41, No. 6-7, Year 2009
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Description
Ethiopia reports the third highest number of extrapulmonary TB cases globally, most of which are lymph node TB (TBLN). We investigated the performance of the available diagnostic tests for TBLN. Fine needle aspirate (FNA) and excision biopsy samples from affected lymph nodes were collected from 150 consenting patients with suspected TBLN visiting regional hospitals in Ethiopia. The sensitivity, specificity, positive (PPV) and negative predictive value (NPV) of histopathology against culture as reference was 92%, 88%, 97% and 77% and of FNA cytology (FNAC) 76%, 88%, 100% and 55%, respectively. Naked eye examination of FNA had 67% sensitivity and 64% specificity. HIV coinfection did not diminish the performance of macroscopic examination, Ziehl-Neelsen stain, histology or cytology examinations. When any positive result in ZN, histopathology or culture was considered confirmatory, clinical diagnosis could be confirmed in 85% of the patients, suggesting that TBLN is over-diagnosed in up to 15% of cases. With combined criteria as reference standard, the sensitivity, specificity, PPV and NPV of FNAC was 72%, 100%, 100% and 55%, respectively. FNAC is a practical tool that can improve the diagnosis of TBLN in high-burden settings. Over-diagnosis alone cannot explain the high burden of LNTB in Ethiopia. © 2009 Informa UK Ltd.
Authors & Co-Authors
Iwnetu, Rachel
Ethiopia, Addis Ababa
Armauer Hansen Research Institute
van den Hombergh, Jan
Ethiopia, Wolayita
Federal Ministry of Health
Woldeamanuel, Yimtubezinash
Ethiopia, Addis Ababa
Addis Ababa University
Asfaw, Mulat
Ethiopia, Harar
Hiwot Fana Specialized University Hospital
Gebrekirstos, Cherinet
Ethiopia
Felege-hiwot Hospital
Negussie, Yared
Ethiopia
Felege-hiwot Hospital
Bekele, Teklu
Ethiopia, Addis Ababa
School of Medicine
Ashenafi, Senait
Ethiopia, Addis Ababa
School of Medicine
Seyoum, Berhanu
Ethiopia, Addis Ababa
Armauer Hansen Research Institute
Melaku, Kibrebeal
Ethiopia, Addis Ababa
School of Medicine
Yamuah, Lawrence K.
Ethiopia, Addis Ababa
Armauer Hansen Research Institute
Tilahun, Hiwot
Ethiopia, Addis Ababa
Armauer Hansen Research Institute
Tadesse, Zerihun Ketema
Ethiopia, Wolayita
Federal Ministry of Health
Aseffa, Abraham
Ethiopia, Addis Ababa
Armauer Hansen Research Institute
Statistics
Citations: 56
Authors: 14
Affiliations: 6
Identifiers
Doi:
10.1080/00365540902897697
ISSN:
00365548
Research Areas
Health System And Policy
Infectious Diseases
Study Locations
Ethiopia