In this article:
- What is tuberculosis?
- Types of tuberculosis infection
- Kinds of tuberculosis test
- Places to run tuberculosis tests in Enugu state
- Samples required for the tests
What is tuberculosis?
Tuberculosis is a disease caused by the infection of majorly the lungs with a bacteria called Mycobacterium. There are a number of species of this bacteria which infect different parts of the body. Mycobacterium tuberculosis infects majorly the lungs while others like Mycobacterium leprae causes leprosy.
Not often, tuberculosis can spread to other parts of the body through the blood stream forming tiny sized granules that cause a serious form of the disease called miliary tuberculosis. It can also infect the skin causing cutaneous tuberculosis.
The disease is infectious and the bacteria is spread from an infected person to others through air droplets expelled while coughing openly. The droplets containing the bacteria may be inhaled by persons close by or who stay close with infected persons. That is why tuberculosis spreads faster in over crowded environments.
Research has shown that Mycobacterium tuberculosis may be able to survive on surfaces that do not have direct contact with sunlight for months, the lenght of time may vary due to other environmental factors, so it is likely that people can get infected when these particles are resuspended in air by sweeping, wind flow etc..
The incubation period for tuberculosis is about 2 to 12 weeks, this is the time between infection and manifestation of signs and symptoms. The signs and symptoms of an infection include coughing for more than 2 weeks that produces phlegm and sometimes is blood stained, chest pain, night fever, weight loss, weakness, etc.
Types of tuberculosis infection
Tuberculosis infection can be latent, active, or drug resistant. Latent tuberculosis is the type of infection where the individual does not develop any signs and symptoms and usually does not transmit it to other persons. However, some circumstances can make the infection erupt and result in active infection. This is often caused by disease conditions that disrupt the immune system such as HIV, diabetes, malnutrition, tobacco usage, alcoholism etc. Latent tuberculosis can be detected by laboratory test and is treatable.
Active tuberculosis infection is the type which the individual presents with signs and symptoms, this type is contagious.
Drug resistant tuberculosis occurs when the tuberculosis bacteria becomes resistant to available anti-tuberculosis medications. There are different degrees of resistance. Resistant to the first line drugs especially rifampicin and isoniazid is referred to as multidrug resistance.
There are also pre-extensive drug resistance and extensive drug resistance which occur when the bacteria is resistant to other higher lines of drugs. Drug resistant tuberculosis develop due to improper medication which can be as a result of inadequate prescription, poor drug quality, or inability of the patient to follow the prescription. Active and latent tuberculosis are treatable, there is a huge benefit with early detection as treatment is given early to prevent damage to the lungs.
Kinds of tuberculosis test
There about 7 kinds of tuberculosis tests that are available.
- Mantoux test (tuberculin skin test). This is an immunological skin tests that is monitored over a 24-72 hours period. It checks for the formation of a wheal (swelling of certain diameters) on the skin due to the immune reaction that occurs when a small amount of fluid containing tubercullin (tuberculosis antigen) is injected under the skin of the lower arm. The formation of a wheal within 24-72 hours indicates a positive test. This test is a screening test, therefore, a positive result is interpreted carefully with reference to the diameter of the wheal formed and the risk factor of the patient. It could show that a person is infected with tuberculosis but does not differentiate whether it is an active or latent infection. A recent vaccination with BCG vaccine can give a false positive test while a false negative can result from recent infection that has not produced sufficient immune response. Therefore further diagnosis and patient assessment is required to rule down and differentiate an actual tuberculosis infection.
- Tuberculosis antibody tests. These are performed to detect the presence of antibodies against tuberculosis in the patient’s blood. There are different kinds of antibody tests such as Interferon gamma release tests, IgG antibody test which indicates a previous infection, and IgM antibody tests which indicates a recent infection. They however, are not able to differentiate between active and latent infections hence other diagnostic tools may be required. Price N10,000 – N15,000.
- Gene Xpert (MTB/RIF) tuberculosis assay. This is a rapid molecular diagnostic test that simultaneously detects the presence of tuberculosis DNA in the sputum or pus samples of patients as well as genetic mutation associated with resistance to the drug rifampicin. This is the recommended first line test by WHO for persons showing signs and symptoms of tuberculosis infection. It is fast, requiring about 2 hours, and much more accurate, allowing for early detection and treatment of any positive case. It can detect the presence of the tuberculosis bacteria when it is about 1-10 bacteria/ml in the sample. Price N25,000 – N30,000.
- Real time PCR test for tuberculosis. This is also a molecular diagnostic test that detects the presence of tuberculosis DNA in patients samples. It defers from Gene Xpert assay because it does not simultaneously check for rifampicin drug resistance. But it can be used to assay for tuberculosis in other samples such as cerebrospinal fluid, pleural fluid, synovial fluid etc. as well as perform other drug resistance testing. It is fast and has a high level of accuracy as it can detect the presence of tuberculosis bacteria when it is about 1-3 bacteria/ml in the sample.
- Tuberculosis culture test. This is a microbiological technique of growing the bacteria on culture media. This is the gold standard test. It helps to isolate and especially conduct antimicrobial sensitivity testing on the isolates which helps to determine the sensitive drugs to administer to the patients. Although this test procedure is slow requiring about 2 to 6 weeks and also about 3 weeks for sensitivity testing, however, it remains a very important diagnostic tool. It can detect the presence of the tuberculosis bacteria when it is about 10-100 bacteria/ml in the sample. Price N15,000 – N20,000.
- Drug resistance testing. This is the test that helps to determine whether the tuberculosis bacteria that has infected a patient is resistant to any of the anti-tuberculosis drugs especially the first and second line drugs. It can be performed using culture or PCR molecular technique. It is important as it helps in the proper monitoring and surveillance of response to drugs. Price N30,000 – N35,000.
- Tuberculosis Acid fast smear staining. This a staining technique of sputum smears with Ziehl Neelsen’s stain. The presence of the stained bacteria is detected with the use of a microscope. It is used in settings where other advanced diagnostic tools are not available or are expensive to use. It is however, less sensitive that the culture, Gene Xpert, and PCR methods. It can detect the presence of the tuberculosis bacteria when it is about 10,000 bacteria/ml in the sample. Price N5,000 – N10,000.
Places to run tuberculosis tests in Enugu state
- Spectrum Biomedical Services Ltd. This is one of the leading medical laboratories in Enugu state. They offer the following tuberculosis tests:
- Tuberculosis Gene Xpert (MTB/RIF) assay.
- Tuberculosis antibody screening (Interferon gamma releasing assay)
- Location: No 6 Market Road (Beside State Library, Holy Ghost) Ogui Enugu
- Contact phone number: +2348034730673 or +2348183996068
- Safety Molecular Pathology Laboratory. This is a leading molecular laboratory in Enugu state and south east Nigeria. They offer the following tuberculosis tests:
- Tuberculosis Gene Xpert (MTB/RIF) assay
- Tuberculosis culture test
- Tuberculosis antibody (IgG and IgM) ELISA assay
- Tuberculosis acid fast microscopy test
- Tuberculosis drug resistant test
- Location: 44 Rangers Avenue Independence Layout Enugu (Head Office). The nearest landmark is Guarantee Trust bank or Chitis Restaurant Rangers Avenue Independence layout, Enugu.
- Contact phone number: +2348037435616 or +2347088938727
You can browse our directory for other details
Samples required for the tests
- Tuberculosis microscopy is done with a sputum sample.
- Tuberculosis antibody test is done with a blood sample.
- Tuberculosis culture test is done with a sputum sample
- Tuberculosis Gene expert is done with a sputum sample.
- Tuberculosis real-time PCR tests is done with a number of samples which include, sputum, pus, cerebrospinal fluid, synovial fluid, pleural fluid, lymph node aspirate etc.
- Tuberculosis drug resistance test is done with a sputum sample.
This post will be updated periodically with new information on tuberculosis testing centers in Enugu state, Nigeria.
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