Вирусология и микология
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Pneumocystis jirovecii in TB: Smear-Negative and Retreatment Cases at the Coast General Hospital

Saitoti A*, Wamunyokoli F, Njerwanna SL, Christine Bii

The opportunistic fungus Pneumocystis jirovecii causes PneumocystisPneumonia (PCP), a life-threatening infection in HIV/AIDS and other immunocompromised patients. The seemingly low prevalence of P. jirovecii pneumonia in sub-Saharan Africa has been a matter of great debate; unsuitable diagnostic practices have been added to the uncertainty of PCP prevalence. Few studies have evaluated the utility of easily obtainable samples such as expectorated sputum for diagnosis. Smear -ve pulmonary TB is diagnosed according to clinical and radiographic criteria, due to unavailability of mycobacterial cultures. In high seroprevalence areas of HIV/AIDS there’s a concern that other opportunistic infections apart from TB, such as P. jirovecii may be missed. We proposed to determine the prevalence of P. jirovecii in confirmed TB smear negative and retreatment cases at the CGH. Sputum Samples were analyzed by microscopy after Toluidine Blue O staining and by PCR to evaluate the techniques in detecting P. jirovecii. 200 TB smear negative samples were analyzed irrespective of the patients HIV status. Sample analysis by both the staining technique and PCR were compared. We aimed to determine the significance of PCP in TB smear negative and retreatment cases and significance of P. jirovecii in TB smear negative and retreatment cases at the CGH.