Beniam Feleke

Publications (2)0 Total impact

• Article: Prevalence of smear negative pulmonary tuberculosis among patients visiting St. Peter's Tuberculosis Specialized Hospital, Addis Ababa, Ethiopia.

  Kassu Desta, Daniel Asrat, Eshetu Lemma, Mekdes Gebeyehu, Beniam Feleke
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  ABSTRACT: Smear negative pulmonary tuberculosis is an increasing clinical and epidemiological problem, particularly in areas that are affected by the dual tuberculosis/Human immunodeficiency Virus infections. This study was initiated to investigate the value of clinical parameters, chest x-ray findings and culture in the diagnosis of smear negative pulmonary tuberculosis. A cross sectional study was conducted among suspected pulmonary tuberculosis patients visiting St. Peter Tuberculosis Specialized Hospital, Addis Ababa, Ethiopia between November 15, 2004 and October 30, 2005. A total of 297 informed and consented patients with suspected pulmonary tuberculosis were screened for acid fact bacilli by direct smear microscopy. All smear negative pooled sputum samples were further processed for culture using conventional Lowenstein-Jensen solid medium and automated BACTEC MGIT 960 system liquid medium at the Ethiopian Health and Nutrition Research Institute. 247/297 (83.2%) patents with suspected pulmonary tuberculosis have had a negative smear results for acid fast bacilli. Abnormal chest x-ray findings were observed in 196 (79.4%) patients. 43/247 (17.4%) patients whose smears were negative for acid fast bacilli found to be positive for mycobacterial culture. The Mycobacterium species identified were M. tuberculosis (n = 40) (93%) and non-tuberculous mycobacteria (n = 3) (7%). Significant difference was not demonstrated statistically between BACTEC MGIT 960 and Lowenstein-Jensen medium in terms of mycobacterial recovery rate (p > 0.05). The present study showed 82.6% smear negative pulmonary tuberculosis cases were still etiologically unexplained by culture. Therefore, there is a need to develop a scheme to determine the most cost-effective approaches for the diagnosis of smear negative pulmonary tuberculosis in the Ethiopian setting, such as improving the screening method patients with tuberculosis and other chronic pulmonary diseases, chest-x-ray readings and interpretation, specimen collection and processing, smear microscopy, culture and applying laboratory quality control schemes in parallel.
  Ethiopian medical journal 01/2009; 47(1):17-24.
• Source

  Available from: Eshetu Lemma

  Article: Drug susceptibility of Mycobacterium tuberculosis isolate from smear negative pulmonary tuberculosis patients, Addis Ababa, Ethiopia

  Kassu Desta, Daniel Asrat, Eshetu Lemma, Mekdes Gebeyehu, Beniam Feleke
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  ABSTRACT: Drug resistance tuberculosis threatens the National Tuberculosis Control Programme in several countries. A cross-sectional study was conducted during the period between November 2004 and October 2005 to determine drug susceptibility pattern of Mycobacterium tuberculosis (n=37) isolated from smear negative pulmonary tuberculosis patients (PTB), and to access whether these patients are at risk of harbouring drug resistant strains. Of the 37 M. tuberculosis isolates, 21/37 (29.8%) showed resistance to any of the drugs tested. No MDR-TB strains (resistant to INH and Rifampicin) were observed in this study. No statistically significant differences appeared in the frequency and pattern of resistance between isolates from smear positive and negative cases. This study provides potentially valuable information of the value of culture in the diagnosis of smear-negative cases to certain extent in untreated newly diagnosed PTB patients. Smear negative TB patients can harbor drug resistant strains like their smear positive counterparts. [Ethiop.J.Health Dev. 2008;22(2):212-215] Introduction Drug resistance tuberculosis threatens the National Tuberculosis Control Programme in several countries, and the major problem is multidrug resistance TB (MDR-TB) (1). MDR-TB is defined as M. tuberculosis strains that are resistant to at least isoniazid and rifampicin, the two key first line drugs in short course TB-chemotherapy. Resistance to any single TB drug is close to 10% in all African countries surveyed (2). Recently, extensively drug-resistant (XDR) M. tuberculosis (defined as resistant to at least isoniazid, rifampin, and fluoroquinolone, and either aminoglycosides [amikacin, kanamycin or capreomycin or both) is emerging (3). The problem of drug resistant TB exists in different parts of Ethiopia, and data on patterns of resistance among Ethiopian isolates is ranging from 2%-21% for isoniazid, 2%-20% for streptomycin and 14%-15% for any of the drugs tested (4, 5, 6). MDR-TB was also reported in about 1.2% of new cases and 12% of re-treatment cases (5). Little information is available in Ethiopia related to drug susceptibility assay on M. tuberculosis isolates from smear negative and culture positive sputum samples (7). This study was undertaken to determine drug susceptibility pattern of Mycobacterium tuberculosis isolates with special emphasis from smear negative and culture positive TB patients in order to access whether smear negative TB patients poses risk of harbouring drug resistant strains.