20000403

'Culture facility

gold standard

for TB diagnosis'

KARACHI: It is unfortunate that a big city like Karachi had only two laboratories which offer culture facility which is the gold standard for the diagnosis and management of TB patients.

This was stated by Dr Salman H Siddiqui while addressing a workshop of "Recent Advances in the Laboratory Diagnosis of TB", held here on Saturday under the joint auspices of Pakistan Society for Microbiology (PSM) and Liaquat National Hospital (LNH).

Dr Salman Siddiqui, who also conducted the workshop, is a former student of Karachi University and one of the three US scientists honoured as BD Fellow by Becton and Dickenson institution of USA.

During the workshop, Dr Siddiqui discussed in detail the merits and demerits of various tests for the diagnosis of TB as well as the importance of specimen collection, processing, storage and transport.

He said for proper management and treatment of patients, we have to reduce the turnaround time, that is, the point of collection of specimen and the final lab report so that the patient may get the benefit of testing.

He recommended that for a proper diagnosis three separate sputum samples in case of pulmonary TB and gastric aspirate or induced sputum in case of children be collected and cultivated after mild decontamination.

Definitive diagnosis is possible only be culture, he said, adding it allows identification of drug susceptibility profile needed by the physician to treat cases due to multi drug resistant TB strains.

Dr Siddiqui emphasised that the liquid media used in Basctec-TM or MGIT-TM is a highly sensitive and rapid system for culture/sensitivity and accurate diagnosis of TB with a turnaround time of 22 days instead of 68 days by other methods.

Addressing the workshop participants he further said 95 percent of all cases of TB are in developing countries and more than half of these cases are in five countries; Pakistan, India, Nepal, China and Bangladesh.

Earlier, introducing the topic of the seminar PSM Secretary Dr Shahana Kazmi, said that tuberculosis, which is a leading killer of adults in Pakistan and other countries poses a serious challenge to the international public health efforts.

The global resurgence of TB, Dr Shahana said, is being accelerated by AIDS. Among the HIV positive and negative populations, tuberculosis continues to disproportionately affect the socio-economically disadvantaged members of our community.

She said Pakistan is one of hte nine high burden countries with a total of 2.2 million cases of TB. Though the causative organism was discovered more than 100 years ago and drugs for treatment came in the next 50 years, still somewhere someone is dying of TB every 10 seconds.

Almost everyone could be or should be saved by proper diagnosis and management, she added.

Welcoming the participants, Chief of Infectious Diseases at LNH Dr Naseem Salahuddin, said that the cases of meningeal, pulmonary and extra pulmonary TB are increasing in Pakistan due to lack of proper facilities for diagnosis by culture and antibiotic sensitivity profiles.ÑAPP