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Home > A Comparative Study of the Genotype Mtbdrplus® Assay Against a Standard Culture Method for Diagnosis and Drug Susceptibility Testing of Tuberculosis

A Comparative Study of the Genotype Mtbdrplus® Assay Against a Standard Culture Method for Diagnosis and Drug Susceptibility Testing of Tuberculosis

Thesis Info

Author

Thamaini, Peris W.

Department

Pathology (East Africa)

Program

MMed

Institute

Aga Khan University

Institute Type

Private

City

Karachi

Province

Sindh

Country

Pakistan

Thesis Completing Year

2009

Thesis Completion Status

Completed

Subject

Medicine

Language

English

Added

2021-02-17 19:49:13

Modified

2024-03-24 20:25:49

ARI ID

1676728031647

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Background: Nearly one-third of the global population, i.e. two billion people, is infected with Mycobacterium tuberculosis and is at risk of developing the disease. More than eight million people develop active tuberculosis (TB) every year, with about two million dying from the disease annually. Diagnosis of tuberculosis inKenya remains dependent on smear microscopy. New methods of TB diagnosis are needed which have better accuracy and are still cost effective. Molecular methods of TB diagnosis have come under investigation in a lot of studies recently. However, they have their own limitations including the inability to differentiate between active organisms and dead bacilli in specimens. Aim: To determine the sensitivity and specificity of the Genotype® MTBDRplus assay in the detection of resistance to Isoniazid and Rifampicin in mycobacterium tuberculosis isolates. Materials and methods: This is a descriptive and comparative study in which the performance of a new laboratory assay will be compared to the existing (reference) method. All sputum specimens submitted for TB culture and sensitivity to the Aga Khan University Hospital Laboratory microbiology section during the period from August 2008 – April 2009 were included in the study. All sputum specimens submitted underwent smear microscopy, culture and sensitivity testing by the MGIT 960 system and DNA extraction and Genotype MTBDRplus assay for both the direct specimen as well the positive culture tube. Results: 202 sputum specimens were included in the study. Valid phenotypic DST results were obtained for 135 cultures (68%). The number of strains resistant toRIF and INH was 4.5%, 14% respectively. Valid GenoType® MTBDRplus assay results were obtained for 116 DNA extracts (86%). Sensitivity and specificity of the test for the detection of Isoniazid resistance were 0.68 (95% CI: 0.43 - 0.87) and 0.99 (95% CI: 0.95 - 0.99) respectively. Sensitivity and specificity of the test for the detection Rifampicin resistance was 0.78 (95% CI: 0.40 - 0.97) and 0.99 (95% CI: 0.96 - 1.00) respectively. Comparative analysis demonstrated scientifically acceptable overall agreement between molecular (sputum specimens) and phenotypic DST results as shown below (Cohen’s Kappa = 0.76 (95% CI: 0.59 - 0.93) for Isoniazid resistance and Cohen’s Kappa = 0.81 (95% CI: 0.60 - 1.02) for Rifampicin resistance Conclusions: The Genotype MTBDRplus assay demonstrated acceptable sensitivity and specificity for use in laboratory diagnosis of Tuberculosis and the detection of drug resistance.
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پروفیسر رشید احمد صدیقی

پروفیسر رشید احمد صدیقی
افسوس ہے ابھی مولانا عبدالماجد دریابادی کے اشک ماتم خشک بھی نہیں ہوئے تھے کہ اردو ادب وانشا کے میدان کاایک اورشہسوار گرا یعنی پروفیسر رشید احمد صاحب صدیقی نے کم وبیش پچاسی برس کی عمر میں علی گڑھ میں وفات پائی اور وہیں سپردخاک ہوئے۔ مرحوم کا اصل وطن جونپور تھا لیکن طالب علمی کے زمانہ میں علی گڑھ آئے تو بس یہیں کے ہوکر رہ گئے، یہیں انھوں نے تعلیم حاصل کی۔ اُس زمانہ میں اردو میں ایم۔اے نہیں ہوتاتھا اس لیے فارسی میں ایم۔اے کیا، پھر یہیں اردوکے لیکچرر ہوئے اورایک عرصہ کے بعدریڈر بنے۔ڈاکٹر ذاکر حسین صاحب جن کومرحوم ہمیشہ مرشد کہتے اورلکھتے تھے اُن کی وائس چانسلری کے زمانہ میں پروفیسر ہوگئے لیکن اس عہدہ پرفائز ہوئے ابھی دو ہی برس ہوئے تھے کہ ملازمت سے سبکدوش کردیے گئے۔ یونیورسٹی کے قانون کے مطابق وہ ابھی توسیع کے مستحق تھے لیکن اس زمانہ میں یونیورسٹی میں جو سیاست چل رہی تھی وہ مانع ہوئی اور شیخ عبدالرشید(شعبۂ تاریخ)وغیرہ کے ساتھ یہ بھی ریٹائرڈ کرد یے گئے۔ مرحوم نہایت خوددار اورحساس تھے اس لیے انھوں نے شکوہ شکایت کسی سے نہیں کیا لیکن انھیں اس کااحساس عمر بھررہا چنانچہ وہ علی گڑھ میں ہی اپنے ذاتی طویل و عریض مکان میں ایسے گوشہ نشین ہوکربیٹھ گئے کہ نہ کبھی اردو ڈپارٹمنٹ میں قدم رکھا اورنہ یونیورسٹی کی کسی تقریب،کسی پارٹی اورفنکشن میں کہیں نظر آئے۔
مرحوم نے اگرچہ کوئی مستقل کتاب کبھی نہیں لکھی اورنہ کوئی علمی اورتحقیقی کام کیا لیکن وہ اردو زبان کے عظیم نکتہ دان اورادیب تھے، اس لیے مضامین کثرت سے لکھے جن کے دومجموعے ’ ’طنزیات ومضحکات‘‘ اور ’’مضامین رشید‘‘ کے نام سے طبع ہوکر ارباب ذوق میں مقبول اورمشہور ہوئے۔ علاوہ ازیں بعض خطبات بھی چھپے ہیں۔ ان کااردو، فارسی اور انگریزی ادب...

ماحولیاتی آلودگی اور اس کا سدباب: سیرت نبویﷺکی روشنی میں ایک تحقیقی جائزہ

Today, the whole world is facing the dangerious issues of environmental pollution. There is a lot of piles of garbage, plastic bags and waste are found in common routes and streets, the use of bacterial and antiseptic chemicals, smoking as well as the excessives use of machinery causes the abundance of smoke and due to the noise of vehicles, rugs, motorcycles, factories and airplanes, our daily pollution is increasing daily. As a result, many problems including various types of illness and seasonal variations are becoming a major challenge for today's modern era. In order to deal with it, it is important for us to study and follow the instructions of the Prophet (PBUH). Prophet (PBUH) has taken important measures to protect environmental pollution. He has prescribed some precautionary measures to prevent the spreading of dirt in society and keeping the environment clean to avert the soil pollution. For the purpose of aviation of air pollution, the prophet has ordered to populate it with the livestock andplantation. To cope with water pollution, it was emphasized to keep water clean and cleaness of air from odor and dirt. In this modern era, prevention of environmental pollution without following these instructions is impossible. This article has invesitaged on prevention of enviromental pollution and cleanliness of enviroment in the light of Sīrah.

Constraints, Adaptation, and Outcomes Cao Framework of Participatory Financing in Islamic Banking

In the last couple of decades Islamic banking has adapted significantly to the constraints and thus sustained and grew. This thesis aims to describe the obscured adaptations in the Islamic banking to the prevailing constraints and the outcomes of these adaptations, within the Islamic participatory financing cases as evidence. Participatory financing arrangements including Musharakah and Mudarabah are believed to be the ideal modes of financing as prescribed within extensive Islamic finance literature. Therefore, Islamic banks are, usually, expected to apply participatory financing. In practice, however, the participatory financing is not dominant, primarily, because it is constrained by its inherent uncertainty, it has weak regulation particularly related to its operations, and it has lower demand, as the thesis found in the literature. Recently, however, the makeup of financing portfolio of Islamic banks has shown significant growth in the share of participatory financing. This thesis claims that this growth is because of adaptation in participatory financing to the underlying constraints. The thesis, therefore, aims to theoretically and empirically develop a framework to conceptualize the constraints to participatory financing, the responding adaptation to the constraints, and its outcomes. Three interrelated research objectives are set for this purpose. Firstly, a typology of constraints to the participatory financing is developed through a rigorous systematic literature review and is presented as pre-empirical framework. This typology is important for understanding the adaptation to constraints and its outcomes. Ninety-one most relevant publications are analyzed as qualitative evidence for conceptualizing the constraints. Secondly, the thesis empirically described the adaptations in participatory financing to the constraints, and resulted outcomes. A multiple case-study research is designed using working capital financing (WCF), consumer financing (CF), and commodity operations financing (COF) as the cases. Thirty in-depth interviews are conducted with the Islamic banking personnel dealing in these financings, using snowballing within the cases. Related documents and observations are used too as source of evidence. The data is analyzed through Qualitative Content Analysis (QCA) process within QSR NVivo. The findings are reported as a holistic post-empirical Constraints, Adaptations, and Outcomes (CAO) framework. The CAO framework specify three broad categories of constrains, which are i) uncertainty ii), low demand, and iii) regulatory constraints. The participatory financing has adapted well in terms of i) repositioning to the market, ii) restructuring of its risk management, iii) restructuring the sharing mechanism, and iv) restructuring its operations. As outcomes, i) the repositioning and revised sharing structure has increased the demand of participatory financings, ii) the restructuring of risk management has reduced the uncertainty, andiii) the restructuring of its risk management and operations have made the participatory financing more effective within current regulations. Thus, due to these adaptations the participatory financing has become more viable and has consequently grown significantly in Pakistan. The novel CAO framework provides a base for the theoretical understanding of the current adaptation to constraints within Islamic banking, and specifies its outcomes. Moreover, it can provide bases for policy making to deal with the contemporary and future constraints to Islamic banking to ensure its sustainability and growth.