UNIVERSITAS AIRLANGGA



Detail Article

Indonesian Journal of Clinical Pathology and Medical Laboratory

ISSN 0854-4263

Vol. 18 / No. 3 / Published : 2012-01

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Original Article :

The diagnostic value of tb antigen using rapid test device (tb ag) for pulmonary tuberculosis

Author :

  1. Sri Kartika Sari*1
  2. Aryati*2
  1. Bag PK FK-UNAIR/RSU Dr. Soetomo Surabaya
  2. Bag PK FK-UNAIR/RSU Dr. Soetomo Surabaya

Abstract :

In Indonesia, the diagnosis of pulmonary tuberculosis relies primarily on an identification of acid-fast bacilli on sputum smears. However, microscopic device has several limitations. The sensitivity of microscopic examination is variable. The quality of smear microscopic results is heavily depend on the workload, and the skill of the technician’s reading the slide. TB antigen rapid test device (TB Ag) is fast, easy and does not either need skillness of the operator. The kit detects  specific secreted antigen M. tuberculosis coded by: RD (Region of Difference) 1, RD2 and RD3. These RD1-3  were found deleted from BCG (Bacille Calmette-Guerine) vaccine strain. In the present study, the diagnostic value of TB Ag  was assessed. Sputum samples were examined from 59 suspected tuberculosis patients and 22 non tuberculosis patients. The samples of the suspected tuberculosis patients were collected as three consecutive sputum specimens (spot, morning, spot). The total 199 specimens were examined by sputum smear microscopy and TB Ag. M. tuberculosis culture by using Lowenstein Jensen media, which  was used as a gold standard. The sensitivity and specificity of microscopic sputum smear were 83.8% (95%CI:70.0-89.4) and 96.3% (95%CI:89.8-98.7), respectively. While, the sensitivity and specificity of TB Ag were 72.6% (95%CI:63.9-79.9)  and 90.9% (95%CI:72.2-97.5), respectively. The concordance between microscopic sputum smear and TB Ag was 70.8%. TB Ag can be considered as a new diagnostic tool for the diagnosis of pulmonary tuberculosis, especially  at the health services where there is no expert technician available for microscopic sputum smear examination.     Diagnosis tuberkulosis paru di Indonesia hingga saat ini masih berdasarkan pada pemeriksaan mikroskopis BTA dahak. Mikroskopis BTA memiliki keterbatasan. Kepekaan mikroskopis BTA sangat beragam bergantung beban kerja, ketrampilan, dan motivasi petugas dalam membaca sediaannya. Alat uji antigen TB cepat (TB Ag) uji tertentu yang cepat, mudah, praktis, dan tidak memerlukan ketrampilan khusus. Uji ini untuk menemukan secreted antigen M. tuberculosis yang disandi gen RD (daerah perbedaan/region of difference) 1, RD2 dan RD3. Regio genomik RD1-3 ini terhapus di semua galur M. bovis BCG dan sebagian besar mikobakteria lingkungannya. Tujuan penelitian ini untuk mengetahui nilai diagnostik TB Ag dalam mendiagnosis tuberkulosis paru. Sampel penelitian ini adalah dahak dari 59 orang terduga tuberkulosis dan 22 orang non tuberkulosis. Setiap sampel terduga tuberkulosis diambil tiga (3) spesimen (sewaktu-pagi-sewaktu/SPS), sedangkan sampel non tuberkulosis diambil satu (1) spesimen. Setiap spesimen diperiksa secara mikroskopis BTA (Basil Tahan Asam) dan menggunakan alat uji antigen TB Ag cepat. Kultur M. tuberculosis di media Lowenstein Jensen yang merupakan bakuan emas. Kepekaan dan kekhasan mikroskopis BTA masing-masing 83,8% (95%CI:70,0-89,4) dan 96,3% (95%CI:89,8-98,7). Kepekaan dan kekhasan TB Ag masing-masing 72,6% (95%CI:63,9-79,9)  dan 90,9% (95%CI:72,2-97,5). Kesesuaian hasil periksaan mikroskopis BTA dan TB Ag sebesar 70,8%. Unit pelayanan kesehatan yang belum memiliki petugas terlatih untuk pemeriksaan mikrokopis BTA dapat menggunakan TB Ag untuk membantu mendiagnosis tuberkulosis paru.

Keyword :

Sputum smear microscopy, TB antigen rapid test device, diagnostic values ,


References :

Dorman SE,(2010) New Diagnostic Test for Tuberculoisi: Bench, Bedside, and Beyond USA : Clinical Infectious Diseases

Steingart KR, Ramsay A, Pai M,(2007) Optimizing sputum smear microscopy for the diagnosis of pulmonary tuberculosis USA : Expert Rev Anti Infect Ther

Barman P, Gadre D,(2007) A study of phage based diagnostic technique for tuberculosis India : Indian J Tuberc

5. Cattamanchi A, Davis JL, Pai M, Huang L, Hopewell PC, Steingart KR,(2010) Does Bleach processing Increase the Accuracy of Sputum Smear Microscopy for Diagnosing Pulmonary Tuberculosis USA : Journal of Clinical Microbiology

Lange C & Tori M,(2010) Advances in the diagnosis of tuberculos USA : Respirology





Archive Article

Cover Media Content

Volume : 18 / No. : 3 / Pub. : 2012-01
  1. Prothrombin Time And Activated Partial Thromboplastin Time Test’s Result Using Humaclot Va And Sysmex Ca 500
  2. Association Hla-drb1* And Hla-dqb1* With Serum Igm-rf With Rheumatoid Arthritis
  3. Platelets Of Dengue Hemorrhagic Fever
  4. The Diagnostic Value Of Tb Antigen Using Rapid Test Device (tb Ag) For Pulmonary Tuberculosis
  5. Antimicrobial Susceptibility Test Of Pathogenic Aerobic Bacteria At The Internal Medicine Ward
  6. Correlation Of Liver Functions Test, And The Grade Of Dengue Hemorrhagic Fever In Children
  7. Pulmonary Cryptosporidiosis In Tbc Patients
  8. Mycobacterium Tuberculosis And Pcr
  9. Oral Immunization With 38-kda Adhesin Protein Of Mycobacterium Tuberculosis On Cd8+ T Cells In Lung
  10. Thrombocytes Count In Acute Coronary Syndrome Related To Low Molecular Weight Heparin (lmwh)}
  11. Acute Fatty Liver Of Pregnancy
  12. Cold Agglutinins In A Community Acquired Pneumonia Patient

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