A study on role of cartridge based nucleic acid amplification test (CBNAAT) in diagnosis of genital tuberculosis among patients of infertility and pelvic inflammatory disease

Abstract

Female genital TB (FGTB)– referring to TB of the uterus, fallopian tubes and/or Ovaries. It poses a diagnostic dilemma because of its varied presentations and lack of sensitive and specific methods of diagnosis, though CBNAAT gives rapid result. To study the role of CBNAAT in the Diagnosis of Genital Tuberculosis among infertility and Pelvic Inflammatory Disease (PID) Patients. 102 patient of infertility (52) and chronic PID (50) were enrolled for our cross-sectional study. Mantoux, ESR, Histopathology, CBNAAT was performed in all 102 cases and Hysterosalpingography (HSG), Laparoscopy, Hysteroscopy in selected cases. Patient with clinical features of genital TB, supported with TB suggestive test were diagnosed as high suspicious genital TB (GTB+) and rest Low suspicious GTB (GTB-) cases. 14/ 52 cases of infertility and 18/ 50 cases of chronic PID were clinically diagnosed as High suspicious genital TB (GTB+). In our study, overall Prevalance of GTB was 31.37%, among infertility patient prevalence was 26.92% and among chronic PID was 36%. 16/32 (50%) mantoux positive, 25/32 (78.13%) had increased ESR. On HSG, 10/52 (19.23%) infertility cases, on laparoscopy 24/32 (75%), on endometrial histopathology only 3/32 (9.37%) cases had finding suggestive of TB. CBNAAT could detect tubercular bacilli only in 25% (8/32) TB cases. High index of suspicion for FGTB is must for diagnosis. Unlike Pulmonary TB, role of CBNAAT in the diagnosis of female genital TB is limited. PPV of CBNAAT for diagnosis of GTB is almost 100%.