EVALUATING THE DIAGNOSTIC ACCUARCY OF PLEURAL FLUID ADENOSINE DEAMINASE (ADA) LEVELS IN THE DIAGNOSIS OF PULMONARY TUBERCULOSIS

Abstract

Background: Pulmonary tuberculosis (TB) continues to present a major health problem with special impact on resource-limited areas. Research has shown that measuring Pleural fluid Adenosine Deaminase (ADA) constitutes a promise as an effective biomarker for detecting TB pleuritis. The analysis checks the diagnostic capability of ADA testing in pleural fluid for pulmonary TB identification. Objectives: The aim of this study was to evaluate the pleural fluid ADA value effectiveness for pulmonary tuberculosis diagnosis while analysing ADA detection capability compared to established diagnostic detection. Methodology: A total number of participants was included n=120 being evaluated for TB diagnosis. Researchers examined ADA levels from pleural fluid after which the results underwent comparison with standard diagnostic methods including sputum smear microscopy along with chest X-rays and culture tests. The study team computed sensitivity together with specificity as well as positive predictive value (PPV) and negative predictive value (NPV) and accuracy. A Receiver operating characteristic (ROC) curve analysis helped identify the best suitable ADA cutoff value. Results: The tested population exhibited elevated ADA in pleural fluid which reached 45.8 ± 12.3 IU/L among TB-positive cases while remaining at 18.2 ± 8.5 IU/L among non-TB subjects. An ADA cutoff value of 40 IU/L provided a predictive test with 91.7% sensitivity alongside 83.3% specificity that resulted in 88.3% overall accuracy. The diagnostic value of ADA exceeded both sputum smear microscopy and chest X-rays results. Conclusion: Pleural fluid ADA measurements serve effectively as an accurate diagnostic approach to detect pulmonary TB because they demonstrate both high diagnostic validity and sensitivity levels. The testing procedure of ADA represents an advantageous diagnostic measure which supplements current methods in resource-deprived healthcare environments.