A fast and accurate diagnosis is necessary to control and eliminate tuberculosis (TB). In India TB continues to be a serious public health problem. In this study, diagnostic tests on clinical samples from patients suspected to have TBM were performed and the sensitivity and specificity of the various techniques were compared. The main objective of the study was to compare various staining methods such as acid fast staining and fluorescent staining with conventional polymerase chain reaction and evaluate their sensitivity and specificity for detecting TBM. We have developed specific molecular method suitable for detection of mycobacterium tuberculosis bacteria in CSF of TBM patients. The present study was conducted over a period of one and a half year from March 2014 – August 2015, 100 CSF samples collected from clinically suspected cases of TBM from various wards and ICUs of Gandhi Hospital were tested with smear microscopy, acid fast staining, fluorescent staining and conventional polymerase chain reaction by using different molecular probes. The study results revealed that among 100 clinically suspected cases, 12 cases were confirmed TBM by PCR. The sensitivity and specificity of Ziehl Neelsen staining was 8.3% and 100% respectively. Positive predictive value (PPV) and Negative Predictive Value (NPV) of Ziehl Neelsen staining was 100% and 88.88% respectively when compared to PCR. One sample which was positive by Ziehl Neelsen staining was also positive by PCR. In addition to this, PCR could pick up 11 more cases which were negative by Ziehl Neelsen staining. Sensitivity and specificity of fluorescent staining was 16.6% and 100% respectively when compared to PCR. Positive predictive value and negative predictive values of fluorescent staining was 100% and 89.7% respectively when compared to PCR. Two samples that were positive by Fluorescent staining were also positive by PCR. In addition to this PCR could pick up 10 mores cases which were negative by Fluorescent staining. The p value was found to be significant statistically which is < 0.05. Among 100 clinically suspected cases of TBM, multiplex PCR was able to detect 12 cases where as uniplex PCR detected 2 cases. The study results can be used to improve existing TB diagnosis procedure as well as for comparing the effectiveness of the Polymerase chain reaction with staining methods. TBM is still a diagnostic problem, so we need accurate detection for diagnosis and treatment. PCR is simple, sensitive, reliable and most effective molecular method for detection of TBM in CSF of Tuberculosis patients.

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