Serum Adenosine Deaminase: A Novel Biomarker Tool For The Diagnosis Of Tuberculosis

Raju Pandey¹, Dipesh Tamrakar¹, Suresh Jaiswal¹, Anup Sharma¹, Sujan Koju¹, Surya Ram Duwal¹, Ishor Sharma², Rajesh P Jayaswal³ and Pranay P Pankaj⁴

¹Department of Medical Lab Science, Pokhara University, Kaski, Nepal. ²Department of Public Health, Pokhara University, Kaski, Nepal. ³Department of Paramedical Sciences, Lovely Professional University, Punjab, India. ⁴Department of Zoology, Nagaland University, Lumami, Nagaland, India-798627.

DOI : http://dx.doi.org/10.13005/bbra/2068

ABSTRACT: Tuberculosis is a major health issues worldwide. Every year more than 9 million new cases are reported worldwide with death rate of around 2 million each year. Rapid and accurate diagnosis of tuberculosis in population is most supportive in proper medication and early recovery. The golden standard method for diagnosis of tuberculosis in patient is formerly culture method which is time consuming and cumbersome. Various other techniques used in the diagnosis of tuberculosis have poor sensitivity and specificity however serum adenosine deaminase (ADA) has emerged as a potent biochemical marker that can be used as tool for the diagnosis of tuberculosis for rapid, easy and better result. Increased level of ADA in blood generally indicates the presence of tuberculosis. In the present study, the serum ADA level was examined in 75 healthy control and 75 tuberculosis patients with positive sputum smear for acid fast bacilli (AFB), having clinical symptoms were diagnosed for pulmonary tuberculosis and radiological impression for extra pulmonary tuberculosis. The selection of cases and control were based on the inclusion and exclusion criteria. Samples were collected at the outpatient department of National Tuberculosis Centre, Nepal after asking simple questionnaires. Modified Guisti and Galanti method was adopted for estimation of serum ADA from pooled and processed blood samples. There was significant difference (p<0.001) in mean rank of level of serum ADA among the TB cases to controls. The P-TB had the highest mean rank (116.52) followed by EP-TB (99.48) and control had significantly less mean rank (40.16). At the cut-off point of 25 U/L; sensitivity, specificity, positive predictive value and negative predictive value were 90.7%, 100%, 90.66% and 100% respectively. It can be concluded from data that there were insignificant difference in mean rank among sex wise distribution with p=0.037 and sputum grading wise distribution with p=0.142.

KEYWORDS: Tuberculosis; Adenosine deaminase; Pulmonary tuberculosis; Acid Fast Bacilli; Mycobacterium

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