Article Text

other Versions

PDF
Nasopharyngeal aspiration for diagnosis of pulmonary tuberculosis
  1. Stephen Owens (sowens3{at}mac.com)
  1. Liverpool School of Tropical Medicine, United Kingdom
    1. Isam E Abdel-Rahman (isamsaboni{at}hotmail.com)
    1. Liverpool School of Tropical Medicine, United Kingdom
      1. Stephen Balyejusa (pmusoke{at}mujhu.org)
      1. Makerere University, Kampala, Uganda
        1. Phillipa Musoke (pmusoke{at}mujhu.org)
        1. Makerere University, Kampala, Uganda
          1. Richard Cooke (richard.cooke{at}aintree.nhs.uk)
          1. Medical Microbiology, University Hospital Aintree, United Kingdom
            1. Christopher M Parry (cmparry{at}liverpool.ac.uk)
            1. Medical Microbiology, University of Liverpool, United Kingdom
              1. J B S Coulter (coulters{at}fulwood11.wanadoo.co.uk)
              1. Liverpool School of Tropical Medicine, United Kingdom

                Abstract

                Background: Confirmation of pulmonary tuberculosis in young children is difficult as they seldom expectorate sputum.

                Aim: To compare sputa obtained by nasopharyngeal aspiration and by sputum induction for staining and culture of Mycobacterium tuberculosis.

                Patients and methods: Patients from Mulago Hospital, Kampala with symptoms suggestive of pulmonary tuberculosis, were considered for inclusion in the study. Those with a positive tuberculin test and/or a chest radiograph compatible with tuberculosis were recruited. Infection with human immunodeficiency virus was confirmed by duplicate enzyme-labelled immunosorbent assay or in children <15 months, by polymerase chain reaction. Direct polymerase chain reaction was undertaken on 82 nasopharyngeal aspirates.

                Results: Of 438 patients referred, 94 were recruited over a period of 5 months. Median (range) age was 48 (4-144) months. Of 63 patients tested 69.8% were infected with human immunodeficiency virus. Paired and uncontaminated culture results were available for 88 patients and smear results for 94 patients. Nasopharyngeal aspirates were smear-positive in 8.5% and culture-positive in 23.9%. Induced sputa were smear- positive in 9.6% and culture positive in 21.6%. Overall 10.6% were smear-positive, 25.5% were culture-positive and 26.6% had smear and/or culture confirmed tuberculosis. Direct polymerase chain reaction on nasopharyngeal aspirates had a sensitivity of 62% and specificity of 98% for confirmation of culture-positive tuberculosis.

                Conclusions: Nasopharyngeal aspiration is a useful, safe and low-technology method for confirmation of pulmonary tuberculosis and like sputum induction can be undertaken in outpatient clinics.

                • diagnosis
                • nasopharyngeal aspirates
                • sputum induction
                • tuberculosis

                Statistics from Altmetric.com

                Request permissions

                If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

                Linked Articles

                • Précis
                  BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health