A Hospital Based Study to Compare GENE XPERT (CB-NAAT) and Cytochemical Analysis of Pleural Fluid in Diagnosis of Tuberculosis in Exudative Pleural Effusion at a Tertiary Care Center in Western Rajasthan

Abstract

Background: Pleural fluid analysis is the most useful test in differentiating possible causes and directing further investigations. Pleural fluid Adenosine Deaminase (ADA) levels are high in pleural tuberculosis, although an elevated value is non-specific and may occur in other infection and malignancy. The aim of this study to compared GENE XPERT (CB-NAAT) and cytochemical analysis in patients with exudative pleural effusion in diagnosis of tuberculosis.Materials & Methods: Present study was a hospital based cross-sectional study. All the patients with pleural effusion at our department were undergone diagnostic thoracocentesis. As per Light’s criteria; Patients with transudative pleural effusion were excluded from study. Total 50 patients were eligible as per the inclusion and exclusion criteria and were included in the study. We also recorded detailed history including socio-demographic profile, smoking habits, history of anti-tubercular treatment, occupational history, along with detailed respiratory and other systemic examinations in a pre-structured proforma.Results: Age ranges from 18 to 78 years. Male to female ratio was 3.16:1. 20 (40%) patients had history of addiction and out of which 16 were smokers, 3 were alcoholic and 1 had dual (alcoholic and smoker) addiction. The pleural effusion sensitivity of CB-NAAT was 10% and specificity were 90% in study population. It means positive predictive value in study were only 10 cases sensitive in population.Conclusion: We concluded that CB-NAATs have high specificity and could be used alongside ADA (or interferon-gamma) to increase sensitivity for ruling out disease and NAAT for high specificity to rule it in.