Volume. 35, No. 2 july. 2011 - The Chest and Heart Association of ...

Chest & Heart JournalVol. 35, No. 2, July 2011ORIGINAL ARTICLEFluorescein Diacetate (FDA)” A staining basedmethod for early diagnosis of Category IITreatment Failure Tuberculosis PatientFahmida Rahman 1 , Mostofa Kamal 2 , Md Ruhul Amin Mia 3 , Narayan Chandra Dutta 4 ,Jewel Ahmed 5 , Md Shamim 6AbstractObjectives: Rapid diagnosis of true treatment failure tuberculosis patient amongsuspected cat II treatment failure tuberculosis patients.Design: Prospective type of study among ZN smear positive suspected cat IIfailure TB patients to find out true treatment failure by FDA staining andconventional culture.Result: Total 100 patients of cat II failure ZN positive were included. 90 patientswere FDA positive. Eighty seven (87%) were culture positive. Eighty six (95.5%)were positive by both culture and FDA staining. Sensitivity of FDA staining was98.5%.Conclusion: FDA staining on fresh sputum can be used for early and accuratediagnosis of true treatment failure. This early information is of great advantagein clinical settings to choose an appropriate drug regimen.[Chest & Heart Journal 2011; 35(2) : 103-106]Introduction:Tuberculosis is a major health problem inBangladesh. In 2007 Bangladesh ranked 6 th on thelist of 22 highest TB burden countries in the world1 . Estimates suggest that in Bangladesh about 880new TB cases and 176 TB deaths occur daily 2 .The estimated prevalence of all forms of TB andincidence rates in Bangladesh was 425 and 225respectively per 1, 00,000 per year and themortality rate was 51 per 1,00,000 per year 3 .Diagnosis of Pulmonary tuberculosis in developingcountries mainly depends on result of ZN stainedsputum smear. Treatment regimens are usuallyprescribed without assessing the drug susceptibilityprofile of infecting strain 4 .Category I treatment are given to those patientswho are newly diagnosed TB patients and havenever taken anti-TB drug or have taken anti-TBdrug for less than one month. Treatment durationis six months. If any patient remains smearpositive after 5 th month or later during treatmentof category I, is called category I failure. CategoryII treatments are given to those patients who arepreviously treated with anti-TB drug for more thanone month, relapse cases, category I failure, andpatients with history of drug default. Treatmentduration is eight (8) months. If any patient remainssmear positive after 5 th month or later duringtreatment of category II, that patient is calledcategory II failure. These patients will be treated1. Clinical Pathologist, NICVD2. (Associate prof), NTRL ,NIDCH3. Prof. Abu Ahmed Saleh, Dr. Chandon Kumar Roy, Dept of Microbiology & immunology,BSMMU4. Asstt. Prof, Respiratory medicine , NIDCH.5. Specialist- Laboratory, University Research Co. LLC, Bangladesh.6. NTRL, NIDCHCorrespondence to: Dr. Fahmida Rahman, Clinical Pathologist, NICVD