Sains Malaysiana 49(4)(2020): 785-792

http://dx.doi.org/10.17576/jsm-2020-4904-07

Interferon Gamma Release Assay, A Powerful Tool for the Detection of Human and Bovine Tuberculosis in the Greater Cairo Area Compared to Other Diagnostic Tools

(AsaiPelepasan Gama Interferon, Suatu Alat Penting untuk Pengesanan Tuberkulosis Manusia dan Bovin di Kawasan Kaherah Besar Berbanding dengan Alat Diagnostik Lain)

MIRIHAN A. METWALLY¹, AYMEN S. YASSIN^2*, EMAD M. RIAD³, HAYAM M. HAMOUDA¹ & MAGDY A. AMIN²

¹Department of Microbiology, National Organization of Drug Control and Research (NODCAR), Giza, Egypt

²Department of Microbiology and Immunology, Faculty of Pharmacy, Cairo University

Cairo, 11562, Egypt

³Department of Bacteriology, Animal Health Research Institute, Giza, Egypt

Received: 24 January 2019/Accepted: 20 December 2019

ABSTRACT

Rapid detection is essential for the elimination and control of tuberculosis (TB) worldwide. Our study aimed to show the current and actual patterns of human and bovine TB distribution in the Greater Cairo Area community by the application of different TB diagnostic tools to individuals and farm animals with suspected TB. Both sputum and blood specimens were collected from 150 suspected human cases in the community. Sputum samples were examined using direct microscopy (Ziehl-Neelsen stain), culture on Lowenstein-Jensen medium, and real-time PCR. Blood samples were used for interferon gamma release assay (IGRA). In addition, lymph nodes and blood samples were collected from 57 tuberculin-positive animals. Lymph nodes were examined using direct microscopy (Ziehl-Neelsen stain), culture on Lowenstein-Jensen medium, and real-time PCR. Animal blood samples were also tested with IGRA. Sensitivity and specificity as well as positive and negative predictive values were calculated for all tests. The results showed that for both human and animal samples, IGRA provided the most accurate estimates of current TB infection compared to other tests. Furthermore, IGRA had the highest sensitivity and was the most convenient, proving its superiority compared to traditional methods in showing true levels of TB dissemination. This work shows that IGRA is a powerful tool for detection of TB in suspected humans and farm animals and should be incorporated into routine TB screening programs, which require more than one test.

Keywords: Egypt; interferon gamma release assay; Mycobacterium species; TB Real-time PCR

ABSTRAK

Pengesanan pantas adalah penting untuk penghapusan dan pengawalan tuberkulosis (TB) di seluruh dunia. Kajian kami bertujuan untuk menunjukkan corak terkini dan sebenar taburan TB manusia dan bovin di komuniti kawasan Kaherah Besar dengan penerapan alat diagnostik TB yang berbeza kepada individu dan haiwan ternakan yang disyaki TB. Kedua-dua spesimen kahak dan darah dikumpulkan daripada 150 kes manusia yang disyaki dalam kalanganmasyarakat. Sampel kahak diperiksa menggunakan mikroskopi langsung (stain Ziehl-Neelsen), kultur pada medium Lowenstein-Jensen dan PCR masa nyata. Sampel darah digunakan untuk asai pelepasan gama interferon (IGRA). Sebagai tambahan, nodus limfa dan sampel darah dikumpulkan daripada 57 haiwan positif tuberkulin. Nodus limfa diperiksa menggunakan mikroskopi langsung (stain Ziehl-Neelsen), dikultur pada medium Lowenstein-Jensen dan PCR masa nyata. Sampel darah haiwan juga diuji dengan IGRA. Kesensitifan dan kekhususan serta nilai ramalan positif dan negatif dihitung untuk semua ujian. Hasil kajian menunjukkan bahawa untuk sampel manusia dan haiwan, IGRA memberikan anggaran yang paling tepat mengenai jangkitan TB semasa berbanding dengan ujian lain. Selanjutnya, IGRA mempunyai kesensitifan tertinggi dan paling mudah, membuktikan keunggulannya dibandingkan dengan kaedah tradisi dalam menunjukkan tahap penyebaran TB yang sebenarnya. Kertas ini menunjukkan bahawa IGRA adalah alat penting untuk mengesan TB pada manusia dan haiwan ternakan yang disyaki dan harus dimasukkan ke dalam program pemeriksaan rutin TB, yang memerlukan lebih daripada satu ujian.

Kata kunci: Asai pelepasan gama interferon; Mesir; Mycobacterium species; PCR masa-nyata TB

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*Corresponding author; email: aymen.yassin@pharma.cu.edu.eg