Evidence map›Paper›PMID 25184279›Full record

Trial reportPloS one2014

Concentration of lymph node aspirate improves the sensitivity of acid fast smear microscopy for the diagnosis of tuberculous lymphadenitis in Jimma, southwest Ethiopia.

Mulualem Tadesse, Gemeda Abebe, Ketema Abdissa, Alemayehu Bekele, Mesele Bezabih, Ludwig Apers, Robert Colebunders, Leen Rigouts

Open access · goldAbstract readClinical TrialComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
1.3field-weighted citation impact, top 19% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 23 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 2 institutions in 2 countries.

Mulualem TadesseDepartment of Medical Laboratory Sciences and Pathology, Jimma University, Jimma, Ethiopia.
Gemeda AbebeDepartment of Medical Laboratory Sciences and Pathology, Jimma University, Jimma, Ethiopia.
Ketema AbdissaDepartment of Medical Laboratory Sciences and Pathology, Jimma University, Jimma, Ethiopia.
Alemayehu BekeleDepartment of Medical Laboratory Sciences and Pathology, Jimma University, Jimma, Ethiopia.
Mesele BezabihDepartment of Medical Laboratory Sciences and Pathology, Jimma University, Jimma, Ethiopia.
Ludwig ApersDepartment of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.
Robert ColebundersDepartment of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium; Department of Epidemiology and Social Medicine, University of Antwerp, Antwerp, Belgium.
Leen RigoutsMycobacteriology Unit, Department of Microbiology, Institute of Tropical Medicine, Antwerp, Belgium.
Jimma University · ETInstituut voor Tropische Geneeskunde · BE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTuberculous lymphadenitis (TBLN) is the most common form of extrapulmonary tuberculosis. The cytomorphological features of lymph node smears have reduced specificity for the diagnosis of tuberculosis. The diagnosis of TBLN with direct smear microscopy lacks sensitivity due to the limited number of bacilli in lymph node aspirate. Therefore, we aimed to assess whether the concentration of lymph node aspirate improves the sensitivity of acid fast smear microscopy for the diagnosis of tuberculous lymphadenitis.

methodsA cross-sectional comparative study was conducted on 200 patients clinically suspected for tuberculous lymphadenitis in Jimma, Ethiopia. Lymph node aspirate was collected. The first two drops were used for cytomorphological study and direct acid fast staining. The remaining aspirate was treated with N-acetyl-L-cysteine (NALC) and concentrated by centrifugation at 3000 g for 15 minutes. The sediment was used for acid fast staining and culture. Differentiation of M. tuberculosis complex (MTBC) from non-tuberculous mycobacteria (NTM) was done by para-nitrobenzoic acid susceptibility test.

resultComplete data were available for 187 study subjects. 68% (127/187) were positive for M. tuberculosis on culture. Four isolates, 2.1% (4/187), were identified as NTM. The detection rate of direct smear microscopy was 25.1% and that of the concentration method 49.7%. Cytomorphologically, 79.7% of cases were classified as TBLN. The sensitivity of direct smear microscopy was 34.6%, for concentrated smear microscopy 66.1%, and for cytomorphology 89.8%. Two AFB positive cases on concentration method were non-tuberculosis mycobacteria (NTM). The concentration method yielded a positive result from seven cases diagnosed as suppurative abscess by cytology. Both for the direct and concentration methods the highest rate of AFB positivity was observed in smears showing caseous necrosis alone. Smear positivity rate decreased with the appearance of epithelioid cell aggregates.

conclusionThe concentration of lymph node aspirates for acid fast smear microscopy had significantly higher sensitivity than direct microscopy.

Indexed as

Mycobacterium tuberculosisAcetylcysteineAdolescentAdultAgedBiopsy, NeedleChildChild, PreschoolCross-Sectional StudiesEthiopiaFemaleHumansLymph NodesMaleMiddle AgedNitrobenzoatesAcetylcysteineNitrobenzoates

Identifiers

PMID25184279
PMCPMC4153659
OpenAlexW2155454718

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.