CHETANA VAISHNAVI
Professor & Chief
Division of Clinical Microbiology
Department of Gastroenterology Postgraduate
Institute of Medical Education and Research,
Chandigarh, 160012
India.
Introduction
Tuberculosis
major
public
health
problem
in
developing countries
Mycobacterium tuberculosis (human)
M.bovis (bovine)
M. avium and M. intracellulare (atypical mycobacteria)
In 2006 Global Plan to Stop TB 2006-2015 launched
Epidemic growing by about 1% annually
Each year 9 million new cases; 2 million deaths
85% of cases occur in Africa and Asia (30%; 55%)
India and China together represent 35% of the burden
frequent
in
children
and
people
with
HIV
infection.
More difficult to diagnose
Require invasive procedures & sophisticated lab.
techniques
Diagnosed on the basis of clinical experience
Autopsies
on
patients
with
pulmonary
intestinal involvement in
Diagnostic aids
Microbiological techniques
Smear/Light Microscopy
Concentration
centrifugation/sedimentation/chemical
Fluorescence microscopy
sensitive, specific
starting
point
for
species
identification/drug
antigen
ESAT-6
(early
blood sample by
secretory
antigenic
Immunodiagnostic tests
Laparoscopic findings
Excellent but sparingly used diagnostic technique
Colonoscopic findings
On colonoscopy, up to 8-10 biopsies are generally taken for
Radioimaging methods
Chest radiography
Barium studies
Ultrasonography
Computed tomographic scan
Very useful in diagnosis of abdominal tuberculosis.
Molecular methods
flanking sequences.
rRNA targeting probes are 10-100 fold more sensitive than DNA
targeting
Confirm diagnosis directly in clinical specimens
Lowest detection limit is around 100 organisms
tuberculosis
epidemic
Biggest concern lack of a rapid, simple, inexpensive, pointof-care test
Major step forward an easy to use, inexpensive diagnostic
test (better than smear microscopy) required to deliver results
within minutes without sophisticated equipment or highly-trained
laboratory personnel
Could have
control
Adoption and implementation new tools
THANK YOU