Conventional and Molecular Methods for the Diagnosis of Smear Negative Pulmonary TB and Concordance of Empirical TB Diagnosis with Culture Assay.

Background Ethiopia is among high TB burden countries. The proportion of smear negative patients among pulmonary TB cases was 51%. Nevertheless, microscopy is still a primary tool for TB diagnosis. In the absence of sensitive diagnostic methods, clinicians often make the diagnosis of smear-negative pulmonary TB with information obtained through the clinical history, physical examination and chest X-ray. The treatment of smear negative TB patients with those criteria largely depends on the treating clinician. There is limited data on the utilization of clinical criteria commonly used to initiate TB treatment empirically when culture is used as the reference method. Beside this, there are a number of sensitive diagnostic methods that have a substantial contribution for the diagnosis of smear negative TB patients, but only few studies were conducted in Ethiopia to address this issue.