Indian Journal of Respiratory Care
Volume 11 | Issue 2 | Year 2022

Cartridge-Based Nucleic Acid Amplification Test for the Diagnosis of Pulmonary Tuberculosis: correspondence

Rujittika Mungmunpuntipantip, Viroj Wiwanitkit1

Private Academic Consultant, Bangkok, Thailand, 1Department of Community Medicine, Dr. D. Y. Patil University, Pune, Maharashtra, India

Address for correspondence: Dr. Rujittika Mungmunpuntipantip, Private Academic Consultant, Bangkok, Thailand.

E-mail: rujittika@gmail.com

How to cite this article: Mungmunpuntipantip R, Wiwanitkit V. Cartridge-Based nucleic acid amplification test for the diagnosis of pulmonary tuberculosis: correspondence. Indian J Respir Care 2022;11:193.

Received: 06-01-2022

Revised: 11-02-2022

Accepted: 12-02-2022

Published: 08-04-2022


Dear Editor,

We would like to share ideas on the publication, “A comparative study of cartridge-based nucleic acid amplification test and Ziehl-Neelsen stain with culture on Lowenstein-Jensen media as the gold standard for the diagnosis of pulmonary tuberculosis.”[1] Roy et al. concluded that “whereas culture remains the gold standard for the diagnosis of tuberculosis (TB), CBNAAT has taken over the domain of diagnosis owing to its high sensitivity and rapid turnover time.”[1] We agree that the new alternative technique might be useful for diagnosing TB. Previous reports also showed that the new technique might be superior for diagnosis.[24] However, there are some issues for further studies. First, the cost-effectiveness of the new alternative technique should be assessed similar to Table 1. For a setting with limited resources, cost-effectiveness is an important issue. Second, the new system might be based on a more complex tool. It might require a medical technologist for quality control of analysis. It is questionable whether classical staining is still more functional in rural fieldwork. Finally, it should note that the new technique has a specificity of about 90% compared to culture.[3] Hence, there is still a chance of nondiagnosis, which might lead to difficulty in disease control.

Table 1: Cost-effectiveness analysis comparing between intradermal and intramuscular COVID-19 vaccine administration
Vaccination methods Cost (Euro) Times Cost-effectiveness value (Euro)
Intramuscular 34.32 75 0.458
Intradermal 6.86 38 0.181

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1. Roy RD, Gupta SD. A comparative study of cartridge-based nucleic acid amplification test and Ziehl-Neelsen stain with culture on Lowenstein-Jensen media as gold standard for the diagnosis of pulmonary tuberculosis. Indian J Respir Care 2022;11:39-42.

2. Chandrappa N, Rastogi A, Bhatnagar AK. Cartridge based nucleic acid amplification test is superior in diagnosing lymphnode tuberculosis. Indian J Tuberc 2019;66:402-6.

3. Dayal R, Yadav A, Agarwal D, Kumar M, Kamal R, Singh D, et al. Comparison of diagnostic yield of tuberculosis loop-mediated isothermal amplification assay with cartridge-based nucleic acid amplification test, acid-fast bacilli microscopy, and mycobacteria growth indicator tube culture in children with pulmonary tuberculosis. J Pediatric Infect Dis Soc 2021;10:83-7.

4. Youngs J, Patil S, Jain Y. A prospective study evaluating the impact of cartridge-based nucleic acid amplification test (CBNAAT) on the management of tuberculosis in a low-resource high-burden Indian rural setting. J Family Med Prim Care 2018;7:982-92.

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