Current innovations in medical laboratory diagnosis of Tuberculosis

S. Obadire, O. Mitsan, I. Ige, O. C. Oke, F.O. Odewusi
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Abstract

Tuberculosis (TB) is a major global health problem, ranking as the second highest cause of death from an infectious disease globally, after the human immunodeficiency virus (HIV). Nigeria ranked first in Africa with burden of TB. Tuberculosis is a major public health problem in Nigeria with about 407,000 people infected. The World Health Organization estimates that 120,000 people developed TB in 2019, with 154,000 death of whom, 13% were HIV positive individuals. Among the incident cases, 56% were from the South-East Asia and Western Pacific Regions and one quarter were from Africa. The African continent accounts for the highest rates of cases and deaths relative to population. Traditionally, tuberculosis is mostly being diagnosed by a combination of chest X-rays, the staining of sputum with special dyes followed by microscopy, the growth of Mycobacterium tuberculosis in culture and the Mantoux test. The sputum smear microscopy is easy to do and is very cheap and combined with chest X-rays has been used for a long time by TB control agencies worldwide. However, the sputum smear microscopy (sputum AFB) test has some problems in HIV-positive patients and children also in patients with low bacterial load and in latent TB infections. TB continues to be a complex disease to diagnose and manage due to the chronicity of the disease, the nature of the host-pathogen relationship, and the resulting diversity in its clinical manifestations. Therefore, this review considers recent innovations in TB laboratory diagnosis in conventional (traditional), non- conventional (molecular), serological (immunological) methods and the latest methods of TB diagnosis.
当前结核病医学实验室诊断的创新
结核病(TB)是一个重大的全球健康问题,是全球第二大传染病死亡原因,仅次于人类免疫缺陷病毒(HIV)。尼日利亚的结核病负担在非洲排名第一。结核病是尼日利亚的一个主要公共卫生问题,约有407,000人受到感染。世界卫生组织估计,2019年有12万人患上结核病,其中15.4万人死亡,其中13%是艾滋病毒阳性患者。在这些病例中,56%来自东南亚和西太平洋区域,四分之一来自非洲。相对于人口而言,非洲大陆的发病率和死亡率最高。传统上,结核病的诊断主要是通过胸片、痰液用特殊染料染色、显微镜检查、结核分枝杆菌培养物的生长和曼图克斯试验等综合检查。痰涂片镜检操作简单,价格低廉,并与胸部x光相结合,已被世界各地的结核病控制机构长期使用。然而,痰涂片镜检(痰液AFB)在hiv阳性患者和儿童以及细菌载量低的患者和潜伏性结核感染中存在一些问题。由于结核病的慢性、宿主-病原体关系的性质以及由此导致的临床表现的多样性,结核病仍然是一种难以诊断和管理的复杂疾病。因此,本文综述了结核病实验室诊断在传统(传统)、非常规(分子)、血清学(免疫学)方法和最新结核病诊断方法方面的最新创新。
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