Original Research

The use of real-time polymerase chain reaction and an adenosine deaminase assay for diagnosing pleural tuberculosis

Mulalo Molaudzi, Julitha Molepo
African Journal of Laboratory Medicine | Vol 8, No 1 | a731 | DOI: https://doi.org/10.4102/ajlm.v8i1.731 | © 2019 Julitha Molepo, Mulalo Molaudzi | This work is licensed under CC Attribution 4.0
Submitted: 30 November 2017 | Published: 28 August 2019

About the author(s)

Mulalo Molaudzi, Department of Oral Biological Sciences, University of the Witwatersrand, Johannesburg, South Africa
Julitha Molepo, Department of Oral Biological Sciences, University of the Witwatersrand, Johannesburg, South Africa

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Background: The diagnosis of pleural tuberculosis remains a challenge, because the most widely used conventional diagnostic tools are unable to rapidly detect Mycobacterium tuberculosis in pleural fluid with sufficient sensitivity.

Objectives: The aim of this study was to evaluate the usefulness of an adenosine deaminase assay and real-time polymerase chain reaction (qPCR) in diagnosing pleural tuberculosis.

Methods: One hundred and five consecutive pleural fluid specimens collected between August 2008 and March 2009 were assessed. Among the 105 specimens, 50 (48%) were unconfirmed tuberculosis cases, 21 (20%) were confirmed tuberculosis cases and 34 (32%) were non-tuberculosis cases (controls). Real-time PCR was performed using the Light Cycler Mycobacterium detection kit according to the manufacturer‘s instructions (Roche Diagnostics). An adenosine deaminase assay was carried out using a commercial colorimetric assay kit as a user-defined method on a Beckman DxC 600 Synchron analyser.

Results: The sensitivity of the qPCR was 67% and specificity was 100%. The sensitivity of the adenosine deaminase assay was 80% and specificity was 94%.

Conclusion: The findings show that the adenosine deaminase assay had higher sensitivity than qPCR. Real-time PCR had 100% specificity, thus a combination of the two methods may be useful for the diagnosis of pleural tuberculosis.


Pleural tuberculosis; adenosine deaminase assay; qPCR; real-time polymerase chain reaction


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