Yield & accuracy of Gastric Lavage in non-expectorating adults with Suspected Pulmonary Tuberculosis

  • Lubna Ghafoor Dow University of Health Sciences, Karachi
  • Faisal Faiyaz Zuberi Dow University of Health Sciences, Karachi, Pakistan https://orcid.org/0000-0001-9067-0021
  • Ghulam Muqtada Khan Liaquat University of Medical & Health Sciences, Jamshoro.
  • Maria Ismail Private practice
Keywords: Pulmonary Tuberculosis, Mycobacterium Tuberculosis, gastric lavage, Anti-TB drugs, GXP, yield

Abstract

Objective: To determine the yield of Gastric lavage (GL) in non-expectorating adults with suspected Pulmonary Tuberculosis (PTB) and accuracy of GL-AFB smear with GL-GeneXpert (GXP) by taking AFB culture as gold standard.

Methods: Cross-sectional study on suspected PTB patients was done at Ojha Institute of Chest Diseases during period 16th July 2020 till 15th January 2021. Adult patients of either gender suspected to have PTB and not expectorating were included. GL was performed and sent for AFB smear, GXP and AFB culture. Odds ratio, sensitivity and specificity were calculated.

Results: After informed written consent, 206 patients, mean age was 38.17 ±17.30 years were inducted, including 89 (43.2%) males and 117 (56.8%) females. Gene Xpert, AFB smear & AFB culture were positive in 83(40%), 50 (24%) & 72 (35%) respectively in GL samples. Odds of PTB were 3.95 times higher among patients with ≤1 month of duration of symptoms (aOR 3.95, 95% CI 1.82-8.57, p-value 0.001), 6.24 times higher among patients with weight loss (aOR 6.24, 95% CI 3.03-12.84, p-value <0.001), and 4.22 times higher among patients with cavitation (aOR 4.22, 95% CI 1.99-8.93, p-value <0.001). GL-AFB smear showed sensitivity 63.89%, specificity 97.01%, positive predicted value 92%, negative predicted value 83.3%, and overall diagnostic accuracy 85.4%. Whereas GL-GXP showed sensitivity 94.4%, specificity 88.81%, positive predicted value 81.93%, negative predicted value 96.75%, and overall diagnostic accuracy 90.78%.

Conclusion: Yield of GL significant to detect PTB in suspected cases who are not expectorating. GL-GXP diagnostic accuracy and sensitivity is higher than GL-AFB smear.

doi: https://doi.org/10.12669/pjms.39.5.6972

How to cite this: Ghafoor L, Zuberi FF, Khan GM, Ismail M. Yield & accuracy of Gastric Lavage in non-expectorating adults with Suspected Pulmonary Tuberculosis. Pak J Med Sci. 2023;39(5):1468-1472. doi: https://doi.org/10.12669/pjms.39.5.6972

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Author Biographies

Lubna Ghafoor, Dow University of Health Sciences, Karachi

MD Pulmonology Trainee

 

Ghulam Muqtada Khan, Liaquat University of Medical & Health Sciences, Jamshoro.

Senior Registrar Pulmonology

Maria Ismail, Private practice

Consultant Pulmonologist

Published
2023-08-03
How to Cite
Ghafoor, L., Zuberi, F. F., Khan, G. M., & Ismail, M. (2023). Yield & accuracy of Gastric Lavage in non-expectorating adults with Suspected Pulmonary Tuberculosis. Pakistan Journal of Medical Sciences, 39(5). https://doi.org/10.12669/pjms.39.5.6972
Section
Original Articles