BACKGROUND AND OBJECTIVES: Tuberculosis remains a major health problem, with an estimated 9.6 million deaths every year worldwide  and approximately 1.5 million cases in india , currently on treatment. Diagnosis of extra pulmonary tuberculosis( EPTB) particularly tubercular ascites with lymphocytic predominance remained challenging over decades due to paucibacillary nature of ascitic fluid. The lack of explicit clinical features ascertaining the tubercular infection in cases of cirrhosis of liver, delays diagnosis and treatment of the tuberculosis leading to high mortality rate. The conventional diagnostic methods such as cytology, ADA, ZN staining and LJ culture done from ascitic fluid are not very sensitive for diagnosis of tuberculosis in ascites. Liquid culture methods adopted by most countries in the last ten years have improved the sensitivity to some extent but are time consuming, expensive and need sophisticated laboratory infrastructure. Detection of tuberculosis by CBNAAT in ascitic fluid has improved the sensitivity and specificity, especially when organisms are present in very small amounts. The objective is to diagnose secondary abdominal tuberculosis in patients with cirrhosis of liver and to compare conventional lab parameters with CBNAAT.

MATERIALS AND METHODOLOGY: Observational study of 50 patients attending a tertiary care hospital

Inclusion criteria:

• Adults > 19 years and willing to give informed consent
• Ascites due to cirrhosis of liver.

Exclusion criteria:

• Adults with Ascites due to other causes like Nephrotic syndrome, CCF, Hypoproteinemia, Pancreatitis.

       ·  Primary abdominal tuberculosis

Patients were examined, investigated and evaluated for abdominal tuberculosis. Investigations included:

 1. Ascitic fluid analysis for cell count, cell type, gram’s stain, ZN stain for AFB, sugars, proteins, LDH, ADA, CBNAAT and culture.

2. USG abdomen.

 3. CBC, LFT, PT, APTT, INR.

Collected data was entered into MS excel sheet and was analyzed using software version 24. Data was expressed as descriptive statistics using frequency and percentage. Comparison between the tests was done using chi-square test, p value<0.05 was considered significant and diagnostic accuracy of CBNAAT test was Observed.

RESULTS: Among the 50 cases with liver cirrhosis taken for the study, 7 were CBNAAT TB positive, 2 were AFB positive and 3 were ADA positive. Based on the study conducted, CBNAAT showed significant difference in diagnosis of TB compared to AFB and ADA. CBNAAT was able to detect significantly a greater number of abdominal TB compared to AFB and ADA (p<0.05)

CONCLUSION: The outcome of the present study concludes that CBNAAT has a definite role in the diagnosis of tuberculosis. CBNAAT should be routinely utilized for rapid diagnosis of EPTB along with other conventional methods like AFB smear examination, ADA and culture for better overall results in the diagnosis of EPTB.