[Diagnosis of pulmonary tuberculosis: evaluation of the TB IgA EIA assay in Morroco]

We analysed 2 evaluation lots of the TB IgA EIA test in pulmonary tuberculosis patients [TBp]. Sera were obtained from 345 TBp, 18 healthy subjects [HS], 28 subjects in contact with tuberculous patients [CS] and 16 non-tuberculous lung disease patients [N-TB] for the first evaluation lots and 302 TBp, 60 HS, 21 CS and 18 N-TB for the second. IgA titres against p-90 antigen with the second evaluation lot were significantly higher than the first evaluation lot. With the second evaluation lots, the sensitivity was 78.8% whereas with the first evaluation lot, the sensitivity was 75.9%. Specificity for the first and second evaluation lots was 50% and 70.7% respectively. The sensitivity of this test is still not satisfactory to establish pulmonary tuberculosis diagnosis

Coeliac disease in Sudanese children with clinical features suggestive of the disease

Our prospective hospital- based study examined frequency, clinical presentation and serological indicators of coeliac disease that correlated with intestinal biopsy among high- risk Sudanese children. From July 2001 to July 2002, 80 children aged 15 months- 18 years presented with poor appetite, weight loss, pallor and proximal muscle wasting. We diagnosed coeliac disease in 18 [22.5%]. Antigliadin antibodies [AGA- IgG, AGA- IgA or both] were high in 44; endomysial antibody retest was high in 30. Guardians of 12 children refused consent for biopsy. The other 18 were biopsied: 5 had total villous atrophy, 8 subtotal and 5 partial. All improved with gluten- free diet. Degree of villous atrophy did not correlate with diarrhoea duration or severity, anaemia severity or serological titres

Evaluation of enzyme-linked immunosorbent assay [ELISA] in serodiagnosis of pulmonary tuberculosis

A total of 45 patients with pulmonary tuberculosis and 45 healthy individuals were subjected to chest examination, radiography and ELISA tests for IgA and IgG antibodies. Sputum smear and culture were performed for all tuberculous patients. Evaluated against clinical and radiological diagnosis, ELISA's specificity exceeded 90% in detecting specific IgA and IgG antibodies. The parallel application of ELISA and microscopic examination of sputum yielded 80% sensitivity compared with clinical and radiological examination and 100% sensitivity compared with culture. ELISA alone can be used in ruling out pulmonary tuberculosis but not in diagnosing the disease. However, coupled with microscopic examination, it can be used instead of culture to provide positive diagnosis within 24 hours