Title

Role of CBNAAT and ADA in tubercular pleural effusion diagnosis at BMGMC hospital

Authors

Abhishek Tiwari^1,*, Darshi Rastogi², Ritu Rani Vinodia³ & Sachin Parmar⁴

Affiliation

¹Department of Respiratory Medicine, Birsa Munda Government Medical College, Shahdol, Madhya Pradesh, India; ²Department of Pulmonary Medicine, All India Institute of Medical Sciences, Gorakhpur, Uttar Pradesh, India; ³Department of Otorhinolaryngology (ENT), Birsa Munda Government Medical College, Shahdol, Madhya Pradesh, India; ⁴Department of Community Medicine, V.K.S. Government Medical College, Uttar Pradesh, India; *Corresponding author

Email

Abhishek Tiwari - E-mail: drkatni@yahoo.com; Phone: +91 79991 31219
Darshi Rastogi - E-mail: rrhunjun@gmail.com; Phone: +91 99077 76255
Ritu Rani Vinodia - E-mail: rituvinodia@gmail.com; Phone: +91 76940 59955
Sachin Parmar - E-mail: dr.sachinparmar@gmail.com; Phone: +91 9993813103

Article Type

Research Article

Date

Received February 1, 2026; Revised February 28, 2026; Accepted February 28, 2026, Published February 28, 2026

Abstract

In 2024, 10.8 million new tuberculosis cases were reported globally. Of these, 19% were extrapulmonary (EPTB), meaning the infection occurred outside the lungs. Tuberculous pleural effusion (TPE) is a difficult disease to diagnose because it is only paucibacillary, so consideration should be given to the rapid and easily available diagnostic tools in high tuberculosis prevalence environments. The study was an observational study aimed at assessing diagnostic value of adenosine deaminase (ADA) and Cartridge-Based Nucleic Acid Amplification Test (CBNAAT) in 200 patients with pleural effusion in a tertiary care center. This study established high sensitivity (92.5) but poor specificity (50) of ADA at 40 IU/L cut off; and low sensitivity (28.35) but high specificity (50) of CBNAAT at 40 IU/L cut off. Effusions of tuberculosis were 67 percent with males being the most at 68 percent in the age group of 41 to 50. There was a strong positive correlation between the lymphocyte predominance with the ADA levels (r=0.71, P=0.003) and the CBNAAT positivity (r=0.95, P=0.0015). Thus, we show that ADA is still a useful screening method in tuberculous pleural effusion, especially when it is used in conjunction with lymphocyte-predominant exudates and CBNAAT is a confirmatory study with the further benefit of identifying rifampicin resistance.

Keywords

Tuberculous pleural effusion (TPE), adenosine deaminase (ADA), Cartridge-Based Nucleic Acid Amplification Test (CBNAAT), lymphocytic effusion, diagnostic accuracy

Citation

Tiwari et al. Bioinformation 22(2): 1098-1102 (2026)

Edited by

P Kangueane

ISSN

0973-2063

Publisher

Biomedical Informatics

License

This is an Open Access article which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. This is distributed under the terms of the Creative Commons Attribution License.