PMID- 31599732
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20191114
IS  - 2369-2960 (Print)
IS  - 2369-2960 (Electronic)
IS  - 2369-2960 (Linking)
VI  - 5
IP  - 4
DP  - 2019 Oct 9
TI  - Evaluation of the Yield of Histopathology in the Diagnosis of Lymph Node 
      Tuberculosis in Morocco, 2017: Cross-Sectional Study.
PG  - e14252
LID - 10.2196/14252 [doi]
LID - e14252
AB  - BACKGROUND: The frequency of occurrence of extrapulmonary tuberculosis (EPTB) has 
      been increasing globally over the last two decades. In Morocco, EPTB cases 
      account for 46% of the patients reported with a new episode of tuberculosis (TB). 
      Lymph node TB (LNTB) is the most common form of EPTB. In line with the guidelines 
      of the National TB Program, the diagnosis is mainly based on clinical evidence, 
      including histopathology. OBJECTIVE: This study aimed to evaluate the yield of 
      histopathology testing in the diagnosis of LNTB. METHODS: This cross-sectional, 
      prospective study was conducted among patients with cervical lymph node who were 
      enrolled in the study from November 2016 to May 2017 in three regions of Morocco. 
      We compared the outcomes of histopathological testing with those of bacteriology. 
      Sensitivity (Se), specificity (Sp), positive predictive value (PPV), and negative 
      predictive value (NPV) of histopathology testing were calculated. Culture and 
      Xpert tests were used as the gold standard Laboratoty Testing. RESULTS: A total 
      of 262 patients were enrolled in this study. The Se, Sp, PPV, and NPV of 
      histopathology testing were 95.6% (129/135), 64.6% (82/127), 74.1% (129/174), and 
      93.2% (82/88), respectively, in the presence of granuloma with or without caseous 
      necrosis and were 84.4% (114/135), 74.8% (95/127), 78.1% (114/146), and 81.9% 
      (95/116), respectively, in the presence of granuloma with caseous necrosis. The 
      granuloma with caseous necrosis was associated with increased PPV and Sp of 
      histopathology testing (P<.05). CONCLUSIONS: The presence of the granuloma 
      with caseous necrosis in the histopathological examination had significantly 
      improved the yield of histopathology testing for the diagnosis of LNTB. The 
      findings recommend to maintain histopathology testing in establishing the LNTB 
      diagnosis and to explore other techniques to improve it.
CI  - (c)Kenza Bennani, Asmae Khattabi, Mohammed Akrim, Mohamed Mahtar, Najib Benmansour, 
      Leila Essakalli Hossyni, Mehdi Karkouri, Nadia Cherradi, My Driss El Messaoudi, 
      Ouafae Lahlou, Imad Cherkaoui, Yousef Khader, Abderrahmane Maaroufi, Salah-Eddine 
      Ottmani. Originally published in JMIR Public Health and Surveillance 
      (http://publichealth.jmir.org), 09.10.2019.
FAU - Bennani, Kenza
AU  - Bennani K
AUID- ORCID: 0000-0002-4143-7597
AD  - Direction of Epidemiology and Diseases Control, Ministry of Health, Rabat, 
      Morocco.
AD  - Morocco Field Epidemiology Training Program, Rabat, Morocco.
FAU - Khattabi, Asmae
AU  - Khattabi A
AUID- ORCID: 0000-0001-5194-996X
AD  - Morocco Field Epidemiology Training Program, Rabat, Morocco.
AD  - Ecole nationale de Sante publique, Rabat, Morocco.
FAU - Akrim, Mohammed
AU  - Akrim M
AUID- ORCID: 0000-0003-4587-1750
AD  - Morocco Field Epidemiology Training Program, Rabat, Morocco.
AD  - Ecole nationale de Sante publique, Rabat, Morocco.
FAU - Mahtar, Mohamed
AU  - Mahtar M
AUID- ORCID: 0000-0002-6011-059X
AD  - Otorhinolaryngology Department, Hopital du 20 Aout, Casablanca, Morocco.
FAU - Benmansour, Najib
AU  - Benmansour N
AUID- ORCID: 0000-0002-6928-1969
AD  - Otorhinolaryngology Department, Hopital Hassan II, Fez, Morocco.
FAU - Essakalli Hossyni, Leila
AU  - Essakalli Hossyni L
AUID- ORCID: 0000-0003-0356-1711
AD  - Otorhinolaryngology Department, Hopital des Specialites, Rabat, Morocco.
FAU - Karkouri, Mehdi
AU  - Karkouri M
AUID- ORCID: 0000-0002-6857-7442
AD  - Histopathology Laboratory, Hopital Ibn Rochd, Casablanca, Morocco.
FAU - Cherradi, Nadia
AU  - Cherradi N
AUID- ORCID: 0000-0001-7541-1902
AD  - Histopathology Laboratory, Hopital des Specilaites, Rabat, Morocco.
FAU - El Messaoudi, My Driss
AU  - El Messaoudi MD
AUID- ORCID: 0000-0001-9269-3024
AD  - Tuberculosis Laboratory, Institut Pasteur Maroc, Casablanca, Morocco.
FAU - Lahlou, Ouafae
AU  - Lahlou O
AUID- ORCID: 0000-0003-2208-1617
AD  - Tuberculosis National Reference Laboratory, Institut national d'Hygiene, Rabat, 
      Morocco.
FAU - Cherkaoui, Imad
AU  - Cherkaoui I
AUID- ORCID: 0000-0002-4798-8672
AD  - Direction of Epidemiology and Diseases Control, Ministry of Health, Rabat, 
      Morocco.
FAU - Khader, Yousef
AU  - Khader Y
AUID- ORCID: 0000-0002-7830-6857
AD  - Department of Public Health, Jordan University of Science and Technology, Amman, 
      Jordan.
FAU - Maaroufi, Abderrahmane
AU  - Maaroufi A
AUID- ORCID: 0000-0001-5827-4571
AD  - Direction of Epidemiology and Diseases Control, Ministry of Health, Rabat, 
      Morocco.
FAU - Ottmani, Salah-Eddine
AU  - Ottmani SE
AUID- ORCID: 0000-0002-8344-279X
AD  - Senior Expert on Tuberculosis, Silves, Portugal.
LA  - eng
PT  - Journal Article
DEP - 20191009
PL  - Canada
TA  - JMIR Public Health Surveill
JT  - JMIR public health and surveillance
JID - 101669345
PMC - PMC6819008
OTO - NOTNLM
OT  - Morocco
OT  - histopathology
OT  - lymph node tuberculosis
OT  - positive predictive value
OT  - yield
COIS- Conflicts of Interest: None declared.
EDAT- 2019/10/11 06:00
MHDA- 2019/10/11 06:01
PMCR- 2019/10/09
CRDT- 2019/10/11 06:00
PHST- 2019/04/03 00:00 [received]
PHST- 2019/08/17 00:00 [accepted]
PHST- 2019/07/24 00:00 [revised]
PHST- 2019/10/11 06:00 [entrez]
PHST- 2019/10/11 06:00 [pubmed]
PHST- 2019/10/11 06:01 [medline]
PHST- 2019/10/09 00:00 [pmc-release]
AID - v5i4e14252 [pii]
AID - 10.2196/14252 [doi]
PST - epublish
SO  - JMIR Public Health Surveill. 2019 Oct 9;5(4):e14252. doi: 10.2196/14252.