Accuracy of Radiological Examination and Direct BTA Apusan Compared to Culture in Diagnosing Lung Tuberculosis in Medan

Oct 13, 2025 by wbrum.org 3 views

Accuracy of Radiological Examination and Direct BTA Apusan Compared to Culture in Diagnosing Lung Tuberculosis in Medan

Introduction

Pulmonary tuberculosis is a contagious disease caused by mycobacterium tuberculosis bacteria that are transmitted through the droplet. The diagnosis of pulmonary tuberculosis is usually done through direct sputum examination, thoracic photos, and culture. Early and accurate diagnosis is crucial in treating pulmonary tuberculosis, as it can help prevent the spread of the disease and improve treatment outcomes. In this article, we will discuss the accuracy of radiological examination and direct BTA apusan compared to culture in diagnosing lung tuberculosis in Medan.

Background

Pulmonary tuberculosis is a major public health problem in many parts of the world, including Indonesia. The disease is caused by mycobacterium tuberculosis bacteria that are transmitted through the air when an infected person coughs, sneezes, or talks. The diagnosis of pulmonary tuberculosis is usually done through direct sputum examination, thoracic photos, and culture. Direct sputum examination involves examining a sample of sputum under a microscope to look for the presence of mycobacterium tuberculosis bacteria. Thoracic photos involve taking X-rays of the chest to look for signs of lung damage. Culture involves growing mycobacterium tuberculosis bacteria in a laboratory to confirm the diagnosis.

Research Methods and Results

This research is a descriptive study that uses a diagnostic method, with sputum samples and thoracic photos. Sputum sampling is done randomly, both in the morning and evening, and examined using the Ziehl Nelsen method and culture. The purpose of this study was to determine the effectiveness of direct and radiological BTA examination compared to culture as a gold standard. The research sample was taken from the practice of pulmonary specialist doctors in Medan and BP4 Medan which met the inclusion criteria. Radiological examination and phlegm taking three times for direct and culture and culture is carried out on all patients. The results of the direct BTA examination are then compared to culture.

The results showed that of the 60 samples examined by the BTA Apusan method, the sensitivity value reached 59.38%, specificity of 92.86%, positive prediction value 90.48%, negative prediction value 66.7%, positive possibility ratio 8.31, and a negative possibility ratio of 0.44. On radiological examination, the sensitivity value reached 62.63%, specificity of 82.14%, positive prediction value of 80.77%, negative prediction value 67.65%, positive possibility ratio of 3.67, and a negative possibility ratio of 0.42. Of the 21 samples with positive BTA results, mild lung damage was found in 4 patients (6.7%), moderate damage in 9 patients (15.0%), and area damage in 5 patients (8.3%).

Conclusion and Recommendations

The results showed that radiological examination has a higher sensitivity value compared to the BTA method of direct apusan, compared to culture as a gold standard in BTA examination. Nevertheless, greater clinical benefits are seen in the direct BTA Apusan method because the positive prediction value is higher than the radiological method. Therefore, it is recommended to use both examination techniques, namely BTA Apusan and Radiology, to diagnose pulmonary tuberculosis. This will help increase the accuracy of diagnosis and increase the chances of healing for tuberculosis patients.

The Importance of Using Both Methods

The use of the two methods, namely BTA Apusan Direct and Radiology, provides several advantages:

Increasing the accuracy of diagnosis: The combination of the two methods helps in detecting cases of pulmonary tuberculosis more accurately. *Avoiding the wrong diagnosis: Although radiology has a higher sensitivity, the BTA Apusan method has a higher positive prediction value, thus helping to avoid positive wrong diagnosis. *Speeding up treatment: With a faster and accurate diagnosis, tuberculosis treatment can begin earlier, thereby increasing the chances of healing and reducing the risk of transmission.

Recommendations for Further Research

Further research on the accuracy of diagnosis of pulmonary tuberculosis needs to be done by involving a greater number of samples and considering other factors that may affect the results of diagnosis, such as age, sex, and history of patient disease. In addition, research on the development of new diagnostic methods that are more sensitive and specific to diagnose pulmonary tuberculosis also need to be done, so that the diagnosis can be done faster and more accurately.

Notes

This article is written based on information available in scientific publications and is not a medical recommendation. For the diagnosis and treatment of pulmonary tuberculosis, consult with a pulmonary specialist.

References

World Health Organization. (2020). Tuberculosis.
Centers for Disease Control and Prevention. (2020). Tuberculosis.
Ministry of Health of Indonesia. (2020). Tuberculosis.

Keywords

Pulmonary tuberculosis
Radiological examination
Direct BTA apusan
Culture
Diagnosis
Treatment
Accuracy
Sensitivity
Specificity
Positive prediction value
Negative prediction value
Positive possibility ratio
Negative possibility ratio
Frequently Asked Questions (FAQs) about Pulmonary Tuberculosis Diagnosis

Q: What is pulmonary tuberculosis?

A: Pulmonary tuberculosis is a contagious disease caused by mycobacterium tuberculosis bacteria that are transmitted through the air when an infected person coughs, sneezes, or talks.

Q: How is pulmonary tuberculosis diagnosed?

A: The diagnosis of pulmonary tuberculosis is usually done through direct sputum examination, thoracic photos, and culture. Direct sputum examination involves examining a sample of sputum under a microscope to look for the presence of mycobacterium tuberculosis bacteria. Thoracic photos involve taking X-rays of the chest to look for signs of lung damage. Culture involves growing mycobacterium tuberculosis bacteria in a laboratory to confirm the diagnosis.

Q: What is the difference between radiological examination and direct BTA apusan?

A: Radiological examination involves taking X-rays of the chest to look for signs of lung damage, while direct BTA apusan involves examining a sample of sputum under a microscope to look for the presence of mycobacterium tuberculosis bacteria.

Q: Which method is more accurate, radiological examination or direct BTA apusan?

A: The results of this study showed that radiological examination has a higher sensitivity value compared to the BTA method of direct apusan, but the direct BTA apusan method has a higher positive prediction value.

Q: Why is it recommended to use both examination techniques?

A: Using both examination techniques, namely BTA Apusan and Radiology, provides several advantages, including increasing the accuracy of diagnosis, avoiding the wrong diagnosis, and speeding up treatment.

Q: What are the advantages of using both examination techniques?

A: The advantages of using both examination techniques include:

Increasing the accuracy of diagnosis
Avoiding the wrong diagnosis
Speeding up treatment

Q: What are the limitations of this study?

A: The limitations of this study include the small sample size and the fact that the study was conducted in a specific population.

Q: What are the recommendations for further research?

A: Further research on the accuracy of diagnosis of pulmonary tuberculosis needs to be done by involving a greater number of samples and considering other factors that may affect the results of diagnosis, such as age, sex, and history of patient disease. In addition, research on the development of new diagnostic methods that are more sensitive and specific to diagnose pulmonary tuberculosis also need to be done.

Q: What is the importance of early and accurate diagnosis of pulmonary tuberculosis?

A: Early and accurate diagnosis of pulmonary tuberculosis is crucial in treating the disease, as it can help prevent the spread of the disease and improve treatment outcomes.

Q: What are the consequences of delayed diagnosis of pulmonary tuberculosis?

A: Delayed diagnosis of pulmonary tuberculosis can lead to complications, such as lung damage, and can also increase the risk of transmission of the disease to others.

Q: What are the treatment options for pulmonary tuberculosis?

A: The treatment options for pulmonary tuberculosis include antibiotics, such as isoniazid and rifampicin, and other medications, such as pyrazinamide and ethambutol.

Q: How can pulmonary tuberculosis be prevented?

A: Pulmonary tuberculosis can be prevented by avoiding close contact with people who have the disease, practicing good hygiene, and getting vaccinated against tuberculosis.

Q: What are the symptoms of pulmonary tuberculosis?

A: The symptoms of pulmonary tuberculosis include coughing, chest pain, fever, and weight loss.

Q: How can I get tested for pulmonary tuberculosis?

A: You can get tested for pulmonary tuberculosis by visiting a healthcare provider or a tuberculosis clinic. They will perform a physical examination, take a medical history, and may perform diagnostic tests, such as a chest X-ray or a sputum test.

Q: What are the risks of pulmonary tuberculosis?

A: The risks of pulmonary tuberculosis include lung damage, complications, and transmission of the disease to others.

Q: How can I protect myself from pulmonary tuberculosis?

A: You can protect yourself from pulmonary tuberculosis by avoiding close contact with people who have the disease, practicing good hygiene, and getting vaccinated against tuberculosis.

Q: What are the treatment options for latent tuberculosis?

A: The treatment options for latent tuberculosis include antibiotics, such as isoniazid and rifampicin, and other medications, such as pyrazinamide and ethambutol.

Q: How can I get tested for latent tuberculosis?

A: You can get tested for latent tuberculosis by visiting a healthcare provider or a tuberculosis clinic. They will perform a physical examination, take a medical history, and may perform diagnostic tests, such as a blood test or a chest X-ray.

Q: What are the risks of latent tuberculosis?

A: The risks of latent tuberculosis include developing active tuberculosis, complications, and transmission of the disease to others.

Q: How can I protect myself from latent tuberculosis?

A: You can protect yourself from latent tuberculosis by avoiding close contact with people who have the disease, practicing good hygiene, and getting vaccinated against tuberculosis.

Q: What are the treatment options for drug-resistant tuberculosis?

A: The treatment options for drug-resistant tuberculosis include antibiotics, such as isoniazid and rifampicin, and other medications, such as pyrazinamide and ethambutol.

Q: How can I get tested for drug-resistant tuberculosis?

A: You can get tested for drug-resistant tuberculosis by visiting a healthcare provider or a tuberculosis clinic. They will perform a physical examination, take a medical history, and may perform diagnostic tests, such as a blood test or a chest X-ray.

Q: What are the risks of drug-resistant tuberculosis?

A: The risks of drug-resistant tuberculosis include complications, transmission of the disease to others, and increased risk of death.

Q: How can I protect myself from drug-resistant tuberculosis?

A: You can protect yourself from drug-resistant tuberculosis by avoiding close contact with people who have the disease, practicing good hygiene, and getting vaccinated against tuberculosis.

Q: What are the treatment options for multidrug-resistant tuberculosis?

A: The treatment options for multidrug-resistant tuberculosis include antibiotics, such as isoniazid and rifampicin, and other medications, such as pyrazinamide and ethambutol.

Q: How can I get tested for multidrug-resistant tuberculosis?

A: You can get tested for multidrug-resistant tuberculosis by visiting a healthcare provider or a tuberculosis clinic. They will perform a physical examination, take a medical history, and may perform diagnostic tests, such as a blood test or a chest X-ray.

Q: What are the risks of multidrug-resistant tuberculosis?

A: The risks of multidrug-resistant tuberculosis include complications, transmission of the disease to others, and increased risk of death.

Q: How can I protect myself from multidrug-resistant tuberculosis?

A: You can protect yourself from multidrug-resistant tuberculosis by avoiding close contact with people who have the disease, practicing good hygiene, and getting vaccinated against tuberculosis.

Q: What are the treatment options for extensively drug-resistant tuberculosis?

A: The treatment options for extensively drug-resistant tuberculosis include antibiotics, such as isoniazid and rifampicin, and other medications, such as pyrazinamide and ethambutol.

Q: How can I get tested for extensively drug-resistant tuberculosis?

A: You can get tested for extensively drug-resistant tuberculosis by visiting a healthcare provider or a tuberculosis clinic. They will perform a physical examination, take a medical history, and may perform diagnostic tests, such as a blood test or a chest X-ray.

Q: What are the risks of extensively drug-resistant tuberculosis?

A: The risks of extensively drug-resistant tuberculosis include complications, transmission of the disease to others, and increased risk of death.

Q: How can I protect myself from extensively drug-resistant tuberculosis?

A: You can protect yourself from extensively drug-resistant tuberculosis by avoiding close contact with people who have the disease, practicing good hygiene, and getting vaccinated against tuberculosis.