A Systematic Review of Tuberculosis Diagnosis Using a Breath Test

Karan Madan^*
*Correspondence: Karan Madan, Department of Bioinformatics, Critical Care and Sleep Medicine, All India Institute of Medical Sciences (AIIMS), New Delhi, India, Email:

Keywords

Tuberculosis • Diagnostics • Drugs • Vaccines • Management

Introduction

Mucormycosis is an angioinvasive fungal infection caused by Mucorales fungi. It is classified as rhinocerebral, pulmonary, cutaneous, gastrointestinal, disseminated, or other based on the clinical presentation, which includes uncommon rare forms such as endocarditis, osteomyelitis, peritonitis, renal and so on. The disease was first described in 1876, when Fürbinger described a patient who died of cancer and had a hemorrhagic infarct with fungal hyphae and a few sporangia in the right lung. Arnold Paltauf described the first case of disseminated mucormycosis, which he called "Mycosis mucorina [1].

Description

From November 2015 to February 2016, we conducted a crosssectional study to detect tuberculosis in an isolated indigenous population (Maskoy ethnic group, totaling 160 adults) in Livio Faria, Department of Alto Paraguay, 650 kilometres from Asunción. The Ethics Committee (CEI) of the Central Public Health Laboratory (LCSP) granted ethical approval (International Certification No. FWA00020088), with code CEILCSP No. 66/40915. All adult community members (>15 years old) were approached by their leader after we first informed her about the study's purpose and objectives. As a result of the community's widespread illiteracy, all adults received oral information about the study from their leader. Participants were included after signing informed consent.

The eNose Company conducted the VOC analysis of individual'smell prints.' The methodology for training the artificial neural network (ANN) was previously described in detail. The calibration training dataset from a previous study served as the basis for the analysis of the breath profiles in this study cohort, to which we added 47 participants from the actual study cohort and deblinded their diagnosis (clinical status and microbiological outcomes) to the company in order to further optimise the ANN to perform the analysis of the remaining study participants. The reason for optimising the previous ANN by including participants from the current cohort is that VOCs from this indigenous population have a different genetic background, living circumstances and diet than other populations [2-4].

6 pathogen-free offspring New Zealand's Covance Research Products, Inc. provided white rabbits weighing 2.5-3.5 kg (Denver, PA). Animals were housed in standard cages under biosafety level 3 conditions. Every 3-4 days, all rabbits were sensitised with five subcutaneous injections of 107 heatkilled M. bovis in incomplete Freund's adjuvant. The intradermal injection of 0.1 cc of old tuberculin resulted in the successful acquisition of delayed type hypersensitivity (DTH) reaction 25 days after the last sensitization injection (Synbiotics Corp, Kansas City, MO). The tuberculin reaction was read 48-72 hours later and skin fold thickness in two dimensions was measured. The volume of an oval spheroid formula was used to calculate the results [5].

Conclusion

Despite advances in TB diagnostic tool development over the last decade, more effort is required to have an impact on the time and accuracy of the results. The urea breath test may meet the criteria for service as an effective point-of-care diagnostic, which necessitates a simple, cost-effective and quickly implemented technology. UBT may also be useful for monitoring response to therapy and thus providing early warning of the possibility of drugresistant infections. More clinical trials are needed to compare the benefits of metabolic breath tests to those currently available.

Acknowledgement

None.

Conflict of Interest

There are no conflicts of interest by author.

References

1. Raghu, Ganesh, Yolanda N. Mageto, Diane Lockhart and Rodney A. Schmidt, et al. "The accuracy of the clinical diagnosis of new-onset idiopathic pulmonary fibrosis and other interstitial lung disease: a prospective study." Chest 116 (1999): 1168-1174.

Google Scholar, Crossref, Indexed at

2. Haga, Hans-Jacob, Johan G. Brun, Hilde Berner Berntzen and Ricard Cervera, et al. Calprotectin in patients with systemic lupus erythematosus: relation to clinical and laboratory parameters of disease activity." Lupus 2 (1993): 47-50.

Google Scholar, Crossref, Indexed at

3. Horvath, Istvan, Xueen Jia, Per Johansson and Chao Wang, et al. "Pro-inflammatory S100A9 protein as a robust biomarker differentiating early stages of cognitive impairment in Alzheimer’s disease." ACS Chem Neurosci 7 (2016): 34-39.

Google Scholar, Crossref, Indexed at

4. Fischer, Aryeh, Jeffrey J. Swigris, Roland M. du Bois and David A. Lynch, et al. "Anti-synthetase syndrome in ANA and anti-Jo-1 negative patients presenting with idiopathic interstitial pneumonia." Respir Med 103 (2009): 1719-1724.

Google Scholar, Crossref, Indexed at

5. Hunninghake, Gary W., M. Bridget Zimmerman, David A. Schwartz and Joseph Lynch, et al. "Utility of a lung biopsy for the diagnosis of idiopathic pulmonary fibrosis." Am J Respir Crit Care Med 164 (2001): 193-196.

Google Scholar, Crossref, Indexed at