Early Pulmonary Tuberculosis Diagnosis, Prognosis and Treatment

Abstract Background Delays in diagnosing tuberculosis lead to longer infectious periods, posing a challenge in tuberculosis control. This is particularly relevant in high incidence areas (critical). Thus, the objectives of this work were to characterize tuberculosis diagnosis delay and its components (patient delay and health delay) in incidence critical and non-critical areas in Portugal, as well as associated factors. Methods Notified cases of pulmonary tuberculosis diagnosed due to symptoms (passive screening) in the Portuguese Tuberculosis Surveillance System were analysed (2008-2017). Patient, health and overall delays were calculated. Factors associated with each delays' components were identified utilising Cox regression, while adjusting for sex, age and education level. Analyses were stratified by area type (critical and non-critical). Results Median (1st-3rd quartile - Q1-Q3) delays in patient, health and overall delay in critical areas were: 40 (Q1-Q3: 21-76), 8 (Q1-Q3:1-31), and 65 (Q1-Q3: 40-105) days, respectively; similar delays in non-critical areas were 32 (Q1-Q3:16-63); 9 (Q1-Q3: 1-34) and 58 (Q1-Q3: 35-98), respectively. More recent cases, adults younger than 65 years and alcoholic presented longer patient delays (both areas); healthcare professionals and patients with HIV infection presented shorter patient delays (only critical areas). Tuberculosis high-risk groups (males, alcohol dependency, homelessness, community residency) presented shorter health delays in both areas; drug use also presented shorter health delays but only in critical areas. Existing comorbidities was associated with longer health delays in both areas. Conclusions Patient delays increased between 2008 and 2017. Groups with longer/shorter delays differed between delay type and area type. Intervening in tuberculosis diagnosis delays requires different action for critical and non-critical areas, targeting health literacy from the general population and training of healthcare professionals. Key messages Delays in diagnosing in Portugal are mainly driven by delays in patient seeking care and are longer in areas of higher tuberculosis incidence. Intervening in tuberculosis diagnosis delays in Portugal requires different action in different areas, targeting health literacy in the general population and training of professionals.

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Factors associated with delays in pulmonary tuberculosis diagnosis and treatment initiation in Cali, Colombia

Revista Panamericana de Salud Pública ◽

10.26633/rpsp.2019.14 ◽

2019 ◽

Vol 43 ◽

pp. 1

Author(s):

Cindy Córdoba ◽

Lucy Luna ◽

Diana M. Triana ◽

Freddy Perez ◽

Lucelly López

Keyword(s):

Pulmonary Tuberculosis ◽

Treatment Initiation ◽

Control Program ◽

Diagnosis And Treatment ◽

Individual Treatment ◽

Tb Control ◽

Factors Associated ◽

Tb Treatment ◽

Tuberculosis Diagnosis ◽

Tb Control Program

Objective.To determine factors associated with delays in pulmonary tuberculosis diagnosis and treatment initiation in the city of Cali, Colombia.Methods.This was a retrospective cohort study of cases of tuberculosis (TB) reported in the TB control program of Cali between January and December 2016. The information was collected from the databases of the TB control program, individual treatment cards, and clinical histories. The variables considered were sociodemographic factors, clinical factors, substance use, and performance of the health service.Results.A total of 623 cases were identified, of which 57.0% were male. The median age was 42 years (interquartile range (IQR): 27–60). The median time from onset of symptoms to TB diagnosis was 57 days (IQR: 21–117), and from onset of symptoms to TB treatment initiation was 72 days (IQR: 35–145). A factor associated with longer time from the onset of symptoms to TB treatment was being a previously treated TB patient (coefficient: 123.8 days, 95% confidence interval (CI): 48.3 to 199.3). In contrast, being incarcerated was a protective factor for earlier TB treatment initiation (coefficient: -57.3 days; 95% CI: -92.4 to -22.3).Conclusions.Our results provide important information concerning risk factors that are associated with delays in the diagnosis and treatment of tuberculosis, and that are subject to future interventions. Health insurance program managers must work together with health care providers on issues that include patient care, health promotion, and updating TB protocols and standards.

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The role of bronchoscopy and nucleic acid amplification test in pulmonary tuberculosis diagnosis

10.1183/1393003.congress-2017.pa2694 ◽

2017 ◽

Author(s):

Maria Alvarenga Santos ◽

Joana Branco ◽

Margarida Aguiar ◽

Susana Clemente ◽

Vera Martins ◽

...

Keyword(s):

Nucleic Acid ◽

Pulmonary Tuberculosis ◽

Nucleic Acid Amplification Test ◽

Nucleic Acid Amplification ◽

Tuberculosis Diagnosis

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Sensitivitas Metode Pemeriksaan Mikroskopis Fluorokrom dan Ziehl-Neelsen untuk Deteksi Mycobacterium tuberculosis pada Sputum

Smart Medical Journal ◽

10.13057/smj.v1i2.28704 ◽

2019 ◽

Vol 1 (2) ◽

pp. 56

Author(s):

BETTY SURYAWATI ◽

LELI SAPTAWATI ◽

ASTARI FEBYANE PUTRI ◽

JATU APHRIDASARI

Keyword(s):

Mycobacterium Tuberculosis ◽

Early Detection ◽

Pulmonary Tuberculosis ◽

Sensitivity And Specificity ◽

Smear Microscopy ◽

Microbiology Laboratory ◽

Fluorochrome Staining ◽

Primary Screening ◽

Lowenstein Jensen ◽

Tuberculosis Diagnosis

Background: Detection of fast acid bacteria (FAB) using smear microscopy is used as a primary screening for tuberculosis diagnosis. Previous studies have shown that fluorochrome (Auroamine-rhodamine) staining showed better sensitivity compared to Ziehl-Neelsen (ZN) method in the detection of FAB in sputum. However this method has not been recommended for routine use including in Indonesia. This study aimed to evaluate the sensitivity and specificity of fluorochrome compared to ZN to detect FAB in patient’s sputum.Methods: This study analyzed 60 sputum samples from patients with tuberculosis and suspected pulmonary tuberculosis. Samples were obtained consecutively from microbiology laboratory Moewardi Hospital, Indonesia. Each sample was examined using ZN and fluorochrome staining and cultured in Lowenstein-Jensen (LJ) medium. Data were analyzed using sensitivity and spesificity tests.Results: ZN staining detected FAB in 12 samples (10%), while fluorochrome detected FAB in 17 samples (28%). The sensitivity and specificity of ZN staining were 70% and 90% while these for fluorochrome were 90% and 84%. Conclusions: The sensitivity of fluorochrome staining is better compared to ZN staining. This method can be recommended for early detection of tuberculosis.

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Elevated antigen-specific IFN-γ responses in bronchoalveolar lavage fluid impervious to clinical comorbidities improve the pulmonary tuberculosis diagnosis

Tuberculosis ◽

10.1016/j.tube.2020.101942 ◽

2020 ◽

Vol 122 ◽

pp. 101942

Author(s):

Qinglong Guo ◽

Juanjuan Zhang ◽

Guanqiang Li ◽

Shuyan Liu ◽

Guohui Xiao ◽

...

Keyword(s):

Pulmonary Tuberculosis ◽

Bronchoalveolar Lavage ◽

Bronchoalveolar Lavage Fluid ◽

Lavage Fluid ◽

Tuberculosis Diagnosis ◽

Ifn Γ

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Evaluation of Xpert MTB/RIF Ultra performance for pulmonary tuberculosis diagnosis on smear-negative respiratory samples in a French centre

European Journal of Clinical Microbiology & Infectious Diseases ◽

10.1007/s10096-018-03463-1 ◽

2019 ◽

Vol 38 (3) ◽

pp. 601-605 ◽

Cited By ~ 3

Author(s):

Elisabeth Hodille ◽

Audey Maisson ◽

Laurine Charlet ◽

Clyde Bauduin ◽

Charlotte Genestet ◽

...

Keyword(s):

Pulmonary Tuberculosis ◽

Tuberculosis Diagnosis ◽

Smear Negative

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Effectiveness and trend forecasting of tuberculosis diagnosis after the introduction of rapid molecular testing in a city in south-eastern Brazil

10.21203/rs.3.rs-64464/v1 ◽

2020 ◽

Author(s):

Thaís Zamboni Berra ◽

Dulce Gomes ◽

Antônio Carlos Vieira Ramos ◽

Yan Mathias Alves ◽

Alexandre Tadashi Inomata Bruce ◽

...

Keyword(s):

Pulmonary Tuberculosis ◽

Ecological Study ◽

Extrapulmonary Tuberculosis ◽

Incidence Rates ◽

Molecular Testing ◽

Lung Tuberculosis ◽

Eastern Brazil ◽

Immunodeficiency Virus ◽

Trend Forecasting ◽

Tuberculosis Diagnosis

Abstract Background To evaluate the effectiveness of a rapid molecular test for the detection of tuberculosis and to predict the behaviour of the disease in a municipality of Brazil where tuberculosis is endemic. Methods An ecological study was carried out in Ribeirão Preto-SP on a population of tuberculosis cases notified between 2006 and 2017. Monthly tuberculosis incidence rates and the Average Monthly Percentage Change (AMPC) were calculated. In order to identify changes in the series, the breakpoint technique was performed; the rates were modelled and predictions of the incidence of tuberculosis until 2025 were made. Results AMPC showed a fall of 0.69% per month in tuberculosis and human immunodeficiency virus (TB-HIV) co-infection, a fall of 0.01% per month in general and lung tuberculosis and a fall of 0.33% per month in extrapulmonary tuberculosis. With the breakpoint technique, general and pulmonary tuberculosis changed in structure in late 2007, and extrapulmonary tuberculosis and TB-HIV co-infection changed in structure after 2014, which is considered as the cut-off point. The IMA(3) models were adjusted for general and pulmonary tuberculosis and TB-HIV co-infection, and the AR(5) models for extrapulmonary TB, and predictions were performed. Conclusions It is necessary that the algorithms for the care of a person with tuberculosis are followed and the diagnostic means used correctly in order to break the chain of transmission of tuberculosis and reduce its indexes.

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