Fariba Binesh1, Hadi Jalali2, Mohammad Reza Zare3, Farhad Behravan4, Arefeh Dehghani Tafti5, Fatemah Behnaz6, Mohammad Tabatabaee3, Seyed Hossein Shahcheraghi7. 1. MD, Department of Pathology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. 2. MD, Resident of Pathology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. 3. Bs, Nikoopoor Health Center, Yazd, Iran. 4. Bs, Central Laboratory, Yazd, Iran. 5. Ms, Faculty of Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. 6. MD, Department of Infectious Diseases, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. 7. Ms, Infectious Diseases Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Abstract
INTRODUCTION: Tuberculosis is still a considerable health problem in many countries. Rapid diagnosis of this disease is important, and adenosine deaminase (ADA) has been used as a diagnostic test. The aim of this study was to assess the diagnostic value of ADA in the sputum of patients with pulmonary tuberculosis. METHODS: The current study included 40 patients with pulmonary tuberculosis (culture positive, smear ±) and 42 patients with non tuberculosis pulmonary diseases (culture negative). ADA was measured on all of the samples. RESULTS: The median value of ADA in non-tuberculosis patients was 2.94 (4.2) U/L and 4.01 (6.54) U/L in tuberculosis patients, but this difference was not statistically significant (p=0.100). The cut-off point of 3.1 U/L had a sensitivity of 61% and a specificity of 53%, the cut-off point of 2.81 U/L had a sensitivity of 64% and a specificity of 50% and the cut-off point of 2.78 U/L had a sensitivity of 65% and a specificity of 48%. The positive predictive values for cut-off points of 3.1, 2.81 and 2.78 U/L were 55.7%, 57.44% and 69.23%, respectively. The negative predictive values for the abovementioned cut-off points were 56.75%, 57.14% and 55.88%, respectively. CONCLUSION: Our results showed that sputum ADA test is neither specific nor sensitive. Because of its low sensitivity and specificity, determination of sputum ADA for the diagnosis of pulmonary tuberculosis is not recommended.
INTRODUCTION:Tuberculosis is still a considerable health problem in many countries. Rapid diagnosis of this disease is important, and adenosine deaminase (ADA) has been used as a diagnostic test. The aim of this study was to assess the diagnostic value of ADA in the sputum of patients with pulmonary tuberculosis. METHODS: The current study included 40 patients with pulmonary tuberculosis (culture positive, smear ±) and 42 patients with non tuberculosis pulmonary diseases (culture negative). ADA was measured on all of the samples. RESULTS: The median value of ADA in non-tuberculosispatients was 2.94 (4.2) U/L and 4.01 (6.54) U/L in tuberculosispatients, but this difference was not statistically significant (p=0.100). The cut-off point of 3.1 U/L had a sensitivity of 61% and a specificity of 53%, the cut-off point of 2.81 U/L had a sensitivity of 64% and a specificity of 50% and the cut-off point of 2.78 U/L had a sensitivity of 65% and a specificity of 48%. The positive predictive values for cut-off points of 3.1, 2.81 and 2.78 U/L were 55.7%, 57.44% and 69.23%, respectively. The negative predictive values for the abovementioned cut-off points were 56.75%, 57.14% and 55.88%, respectively. CONCLUSION: Our results showed that sputum ADA test is neither specific nor sensitive. Because of its low sensitivity and specificity, determination of sputum ADA for the diagnosis of pulmonary tuberculosis is not recommended.
Authors: J Dinnes; J Deeks; H Kunst; A Gibson; E Cummins; N Waugh; F Drobniewski; A Lalvani Journal: Health Technol Assess Date: 2007-01 Impact factor: 4.014