Clinical And Laboratory Evaluation Of Ascites For Tuberculosis In Patients With Cirrhosis Of Liver. Comparison Of Conventional Lab Parameters With Cbnaat

Background And Objectives: Tuberculosis remains major health problem, with an estimated 9.6 million<br> deaths every year worldwide. Diagnosis of Extrapulmonary tuberculosis (EPTB) particularly tubercular ascites<br> with lymphocytic predominance remains a challenge over decades due to paucibacillary nature of ascitic fluid.<br> Detection of tuberculosis by CBNAAT in ascitic fluid has improved the sensitivity and specificity. The<br> objectives are to diagnose secondary abdominal tuberculosis in patients with cirrhosis of liver and to compare<br> conventional lab parameters with CBNAAT.<br> Methodology: After institutional ethics committee approval and written informed consent from participants, an<br> observational study was conducted among 31 patients with ascites due to cirrhosis of liver above 18 years age<br> attending Rajarajeswari Medical College and Hospital.<br> Results: Among the 31 cases with liver cirrhosis, four were diagnosed with abdominal tuberculosis. All four<br> were CBNAAT positive, one among the same population was AFB positive and 3 were ADA positive. Based<br> on the study conducted, CBNAAT showed higher sensitivity and its comparison with AFB gave a ‘p’ value of<br> 0.04, showing statistical significance. Whereas comparison of CBNAAT with ADA gave a ‘p’ value of 0.32,<br> showing no statistical significance.<br> Conclusion: The outcome of the study concluded that CBNAAT has a definite role in the diagnosis of<br> abdominal tuberculosis. CBNAAT should be routinely utilized for rapid diagnosis of EPTB along with other<br> conventional methods like AFB smear examination, ADA and culture for better overall results in the diagnosis<br> of EPTB.<br>