Sensitivity And Specificity Of Microscopic Examination Of Acid Fast Bacillus Using Direct And Centrifugation Method In Pulmonary Tuberculosis Patient In Work Area Of Puskesmas Kabila

Abstrak

Tuberculosis (TB) remains a major public health problem worldwide, particularly in developing countries. Microscopic examination of Acid-Fast Bacilli (AFB) is commonly used for pulmonary tuberculosis diagnosis because it is simple, rapid, and cost-effective. However, the sensitivity of direct smear microscopy is often limited by low bacillary concentrations in sputum specimens. Centrifugation has been proposed as a concentration technique to improve AFB detection. This study aimed to compare the sensitivity and specificity of direct smear microscopy and centrifugation methods in detecting AFB among pulmonary tuberculosis patients. A diagnostic test study was conducted in the working area of Kabila Public Health Center. A total of 23 pulmonary tuberculosis patients were selected using purposive sampling. Sputum specimens from each participant were examined using both direct and centrifugation methods. Diagnostic performance was evaluated by calculating sensitivity and specificity values using reference standard data. The majority of respondents were aged 51–60 years (39.1%), male (82.6%), and had a senior high school education (39.1%). The direct microscopy method showed a sensitivity of 86% and a specificity of 100%, whereas the centrifugation method demonstrated a sensitivity of 95% and a specificity of 100%. The centrifugation method exhibited higher sensitivity while maintaining the same specificity as the direct method. These findings indicate that centrifugation improves the detection of AFB in sputum specimens and may serve as a useful alternative approach for supporting pulmonary tuberculosis diagnosis in laboratory settings.