BTA examination, sputum test for tuberculosis (TB)

Definition

What is a BTA examination?

Tuberculosis (TB) is an airborne disease caused by a bacterial infection Mycobacterium tuberculosis. People who are suspected of having this bacterial infection are advised to carry out diagnostic tests for TB so that infection prevention measures can be taken.

The examination of acid-resistant bacteria (BTA) is one of the methods used to detect the bacteria that cause tuberculosis because these bacteria can live in an acidic environment. This test uses a sputum sample from a person with tuberculosis, so this test is also often called a sputum test.

Under certain conditions, a BTA test can also be done using samples from your blood, feces, urine and bone marrow. A sample other than sputum is used if the doctor suspects tuberculosis bacterial infection in an organ other than your lungs.

In Indonesia, the Ministry of Health uses the BTA test as the main method of diagnosis for TB, supported by chest X-ray or chest X-rays, as well as sensitivity testing in the early stages of disease detection.

When should I take the BTA test?

AFB is a test that needs to be done when you show signs and symptoms of a lung infection, especially those caused by the bacteria that cause tuberculosis or Mycobacterium tuberculosis.

Some of the symptoms of TB that indicate you should undergo a smear test are:

• Cough won't heal for 3 weeks or more
• Drastic weight loss
• Fever
• The body shivered
• Weakened body
• Night sweats

In addition, if you experience symptoms related to extrapulmonary TB (TB infection that occurs in organs other than the lungs), you are also advised to take this test.

Some of the symptoms of extra-pulmonary TB that you may need to watch out for are back pain (bone tuberculosis), body weakness due to anemia (bone marrow TB), headaches, and impaired consciousness (TB meningitis).

If you have had other tests to detect TB bacterial infection, such as the Mantoux test or the IGRA test, and both tests are positive, sometimes you will need to have another smear sputum test to confirm.

People who have risk factors for TB are also advised to get a smear test. The groups of people who are recommended to undergo a smear test are:

• People who have close contact with people with active TB, such as living at home or meeting up frequently.
• People who live in countries with a high incidence of tuberculosis, such as countries in Southeast Asia, Africa and South America.
• People who work or live in homes, clinics, hospitals, prisons, or shelters. Especially if these places are filled with active TB sufferers.
• People who have HIV / AIDS, rheumatoid arthritis, or other diseases that affect the body's immune system.

Precautions and warnings

What should I know before undergoing a BTA examination?

In general, the AFB test is a relatively safe method of diagnosis of TB and does not cause serious side effects.

If you are unable to expel phlegm, you will be given a sputum induction medication, which can help cough and expel phlegm. If sputum induction fails, a method of sputum collection can also be performed using bronchoscopy.

The sampling method in the BTA test may cause some side effects, although they are very rare. The risks of side effects that may arise if you do AFB by bronchoscopy are:

• Fever
• Bleeding cough
• Pneumonia
• Pneumothorax
• Difficulty breathing

Process

What should I do before undergoing a BTA test?

The smear examination is a relatively simple test. So, you don't need any special preparation. However, it's a good idea before you undergo the examination, you brush your teeth and rinse your mouth first after waking up in the morning. When cleaning teeth, avoid using mouthwash or mouthwash.

In addition, you are not allowed to eat or drink anything before having this sputum test.

How is the process of checking BTA?

Depending on how the sputum sample is taken, the steps for a typical BTA test are as follows:

1. Sampling of sputum

The medical personnel will provide a container to store your sputum. You will be asked to take deep breaths, hold for 5 seconds, and exhale slowly.

Furthermore, the doctor or medical personnel will ask you to undergo the following procedures:

• Cough hard until you can feel phlegm rising up into your mouth.
• Dispose of sputum into the container provided.
• Close the container tightly.

Sputum samples are usually taken 3 times in a row (during, in the morning, and at any time). The first sampling is done with the medical team, which is when you visit the doctor for the first time (while).

After that, you will be asked to do your own sputum collection at home the next day (morning). After that, when you deliver the second sputum sample to the doctor, the third sputum sample will be taken by the medical team or the doctor (on time).

BTA is a test that can also be done on children, but with a slightly different method. Children may have difficulty expelling phlegm on their own. Usually, a child's sputum can be collected with the help of tools nebulized hypertonic saline.

Functionnebulized hypertonic salinefor the BTA test in children is to thin the mucus and phlegm in the respiratory tract, so that the phlegm is easier to pass.

When collecting sputum at home, the container containing the sputum sample should be kept in the refrigerator for 24 hours. Avoid storing sputum samples in temperatures that are too cold such as inside freezer.

2. Bronscoscopy

If you have trouble expelling phlegm, your doctor will recommend the bronchoscopy method. Bronscoscopy in the BTA test is a method of inserting a special tube equipped with a camera into your mouth. However, before undergoing this procedure, you will be sedated first.

The bronchoscopy tube will be inserted into the part of the respiratory tract that contains phlegm. The phlegm will then be aspirated and immediately stored in a special container.

After the sample is taken, the medical personnel will store the sample in the laboratory at room temperature for 2 days. In that time span, the bacteria in the sample will grow and reproduce. The bacteria will be given a special dye, heated, and washed in an acid solution.

What should I do after taking the BTA test?

After the BTA test is complete, you can return to your daily activities as before. The doctor will then explain the test results that have been linked to the physical exam as well as your medical history.

Explanation of the test results

What do the results of the BTA examination that I get mean?

Guidelines for reading BTA test results based on the Lab Tests Online site are as follows:

Negative result

A negative test result indicates that no tuberculosis bacterial infection has occurred.

If the results of the three BTA tests are negative but you feel the symptoms of tuberculosis, the health problems that arise may be caused by a bacterial infection or other respiratory disease.

Usually, the doctor will give you a non-OAT (anti-tuberculosis) antibiotic to drink for some time.

Another possible interpretation of a negative smear test result is the number of bacteria M. tuberculosis too little to be detected under a microscope.

Positive result

If only one of the three samples is positive, this indicates the presence of bacteria in your body. To determine whether TB bacteria or not, you will be asked to do a microscopic sputum examination or culture.

This culture examination will be carried out using the method nuclear acid amplification test (NAAT). Your doctor may also ask you to do a chest or chest x-ray if needed.

Meanwhile, if the results of the majority of sputum tests (2 of 3 samples) or all of them are positive, it is likely that the doctor will prescribe a combination of TB drugs.

The decision to give drugs may be taken after the doctor has performed other TB supporting tests so that he is absolutely sure of the diagnosis of TB.