Tuberculosis Is Among the Major Infectious Killer Diseases

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Tuberculosis (TB), a deadly contagious disease is among the three major infectious killers that causes high mortality and morbidity, worldwide.1 Tuberculosis infects one-third of the world's population with an estimated 8.7 million new cases and 1.4 million deaths every year (WHO, 2012)2. Tuberculosis prevention has become more complex due to increased resistance against different antibiotics including rifampicin.3
TB is a socio-economic disaster that is occurring worldwide, especially in Asia and Africa.4 Pakistan is ranked 6th in terms of estimated number of the tuberculosis cases by World Health Organization (WHO) among high burden countries.5It is the second leading cause of adult death in impoverished communities of Pakistan.6
Mycobacterium tuberculosis (MTB) is the main causative organism which attacks the lungs but can also infect other organs of the body. M.tuberculosis is an intracellular pathogen that is highly adapted to human.7The bacterium spread primarily through aerosolized infectious particles generated from coughing and sneezing by individuals with pulmonary tuberculosis and less commonly via skin wounds 8. The most important factors influencing the current TB epidemic in resource poor setting are closely related to malnutrition, overcrowded living conditions and lack of access to free or affordable health care services.9
Early diagnosis of tuberculosis is essential in limiting the spread of mycobacterium tuberculosis infection due to primary route of infection in humans. Sputum smear microscopy has remained the corner stone of TB diagnosis in the global strategy to control the disease. 10 The global targets for TB control, adopted by World Health Assembly, are to cure 85% of the newly detected smear positive T...

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...istics of diagnostic accuracy of ELISA have been also reported in different studies. 22,23
As far as serology in extra-pulmonary tuberculosis is concerned, different studies regarding antibodies detection in Mycobacterium Tuberculosis have shown good results with high sensitivity and specificity.24
In a study for comparison of conventional method AFB smear with PCR technique for detection Tuberculosis conducted in Sudan at 2004 , showed microscopic sensitivity was 65% and the specificity was 90.5%,Whereas sensitivity of PCR was 88.5% and specificity was 98.6 %.They concluded that though PCR sensitivity was 13.1% higher than smear microscopy .25
In a recent study, the diagnostic role of XpertMTB/RIF demonstrated sensitivities of 98.2% and 72.5% with smear-positive and negative TB, respectively. The tests specificity was 99.2% in patients without Tuberculosis. 26

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