Comparison of Xpert MTB/RIF Assay and the Conventional Sputum Microscopy in DetectingMycobacterium tuberculosisin Northern Thailand

Background.Despite low sensitivity in detection ofMycobacterium tuberculosis, sputum acid-fast smear remains the main diagnostic method. This study aimed to compare the diagnostic performance of Xpert MTB/RIF assay versus conventional sputum acid-fast smear.Materials and Methods.A cross-sectional study was conducted at Chiang Mai University Hospital, Thailand. Patients who were ≥15 years old and had clinically suspected pulmonary tuberculosis were included.Results.109 specimens from 57 patients were included. Using MGIT sputum culture as a reference standard, the sensitivity (SEN) and specificity (SPEC) for Xpert were 95.3% (95% CI, 84.2%, 99.4%) and 86.4% (95% CI, 75.7%, 93.6%). The SEN and SPEC for sputum acid-fast smear were 60.5% (95% CI, 44.4%, 75.0%) and 98.5% (95% CI, 91.8%, 100%). Xpert had significantly higher sensitivity (pvalue < 0.001) and lower specificity (pvalue = 0.022) than sputum acid-fast smear. Among 43 culture-provenM. tuberculosisspecimens, sensitivity of Xpert was 100% (95% CI, 86.7%, 100%) in acid-fast positive smears (n=26) and 88.2% (95% CI, 63.5%, 98.5%) in acid-fast negative smears (n=17).Conclusions.The good sensitivity and specificity of Xpert assay in detectingM. tuberculosisfrom sputum specimens may help in early diagnosis and treatment of pulmonary tuberculosis, particularly among patients who had acid-fast negative sputum smear.

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Tuberculosis Status and Coinfection of Pulmonary Fungal Infections in Patients Referred to Reference Laboratory of Health Centers Ghaemshahr City during 2007-2017

Ethiopian Journal of Health Sciences ◽

10.4314/ejhs.v28i6.2 ◽

1970 ◽

Vol 28 (6) ◽

Author(s):

Mohammad Reza Jabbari Amiri ◽

Rora Siami ◽

Azad Khaledi

Keyword(s):

Pulmonary Tuberculosis ◽

Fungal Infections ◽

Cross Sectional Study ◽

Health Centers ◽

Sputum Smear ◽

P Value ◽

Reference Laboratory ◽

Cross Sectional ◽

Pulmonary Fungal Infections ◽

Student’S T

BACKGROUND: Pulmonary tuberculosis is one of the most important health concerns. Pulmonary fungal infections have clinical and radiological characteristics similar to tuberculosis which may be easily misdiagnosed as tuberculosis. This study aimed to evaluate tuberculosis (TB) status and coinfection of TB with pulmonary fungal infections in patients referred to reference laboratory of health centers Ghaemshahr city during 2007-2017.METHODS: This cross-sectional study was conducted during eleven years, between 2007 2017, on 3577 patients with suspected TB referred to health centers of Ghaemshahr City. For isolation, sputum smear preparation and Ziehl-Neelson staining in companying with microscopy direct observation and KOH 10% + white Calcofluor staining was used. The culture of fungi was performed on Sabouraud Dextrose agar, Czapek and chrome agar media. Then, data were analyzed using SPSS software (version 16) through Student's t-test, Fisher test, and Odds Ratio. P values <0.05 were considered statistically significant.RESULTS: Of 3577 patients, 10731 smears were prepared, 3.6% (n=130) of patients were identified as smear-positive pulmonary tuberculosis, 86.4% (n=3090) were smear negative and 10% (n=357) drug-resistant TB. The mean age of patients was 48±1.8 years. With increasing age, the prevalence of TB has increased which was statistically significant (P value <0.05). Prevalence of tuberculosis in the age group over than 57 years in males and females had an ascending trend. Amongst the positive tuberculosis patients, 16/130 cases (12.3%) had the coinfection of TB with fungi microorganisms.CONCLUSION: Our findings showed the coinfection of fungi agents in patients with tuberculosis that should be considered.

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Risk factors for mortality among inpatients with smear positive pulmonary tuberculosis

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.35.5.919 ◽

2019 ◽

Vol 35 (5) ◽

Cited By ~ 1

Author(s):

Sidra Hameed ◽

Faisal Faiyaz Zuberi ◽

Sagheer Hussain ◽

Syed Khalid Ali

Keyword(s):

Risk Factors ◽

Pulmonary Tuberculosis ◽

Demographic Data ◽

Sampling Technique ◽

Cross Sectional Study ◽

University Hospital ◽

Smoking History ◽

Cross Sectional ◽

Creative Commons ◽

Smear Positive Pulmonary Tuberculosis

Objective: To evaluate risk factors having significant effect on mortality of smear positive Pulmonary Tuberculosis (PTB) inpatients. Methods: A descriptive cross-sectional study was conducted at Ojha Institute of Chest Diseases, Dow University Hospital Ojha Campus, Karachi. One hundred and seventy (170) inpatients of smear positive PTB confirmed by Acid Fast Bacilli (AFB) smear, aged between 13-80 years were enrolled by using consecutive sampling technique while patients with drug resistant Tuberculosis (TB) and extra pulmonary TB were excluded from the study. Selected patients were interviewed for collecting demographic data and risk factor data by using a standard questionnaire. Results: Out of 170 PTB inpatients, mortality was observed in 23 (13.5%) patients among which male patients were 12 (52.2%), and female were 11 (47.8%). Mortality was significantly associated with increasing age (p=0.003), socioeconomic status (p=0.019), anemia (p=0.03), Chronic Liver Disease (CLD) (p=0.005), Diabetes Mellitus (DM) (p=0.001), Human Immunodeficiency Virus (HIV) (p=0.007), Hypertension (HTN) (p=0.006), recurrent TB (p=0.001), and smoking (p=0.001). Conclusion: Increasing age, poverty, smoking history, and presence of comorbidities like DM, CLD, HIV, hypertension, and anemia are associated with higher mortality in smear positive PTB cases. doi: https://doi.org/10.12669/pjms.35.5.919 How to cite this:Hameed S, Zuberi FF, Hussain S, Ali SK. Risk factors for mortality among inpatients with smear positive pulmonary tuberculosis. Pak J Med Sci. 2019;35(5):---------. doi: https://doi.org/10.12669/pjms.35.5.919 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Compliance to Directly Observed Treatment Short Course (DOTS) Chemotherapy among the Patient of Pulmonary Tuberculosis in Banke District of Nepal

Journal of Health and Allied Sciences ◽

10.37107/jhas.45 ◽

2019 ◽

Vol 3 (1) ◽

pp. 17-20

Author(s):

Ram Bahadur Nepali ◽

Damaru Prasad Paneru

Keyword(s):

Alcohol Consumption ◽

Pulmonary Tuberculosis ◽

Public Health Problem ◽

Treatment Compliance ◽

Cross Sectional Study ◽

Sputum Smear ◽

Cross Sectional ◽

Regular Treatment ◽

Drinking Habits ◽

Smear Positive Pulmonary Tuberculosis

Tubercular infection is still a pervasive public health problem in Nepal despite the massive efforts of National Health Service stakeholders. High bacterial infectivity, transmissibility, increasing drug resistance and non compliance to the therapy have been adding up challenges to prevention and control of tuberculosis. This study was conducted to observe the treatment compliance pattern among new pulmonary sputum smear positive cases of tuberculosis. A cross sectional study was carried out in the year 2009. The 114 new smear positive pulmonary tuberculosis patients registered in the six selected DOTS centres of the Banke Disrtict were randomly selected. Participants were selected from each DOTS centre by probability proportionate sampling methods. Data were analyzed by SPSS (11.0 Version) and P< 0.05 was considered as significant. Overall compliance to DOTS was 86.80 percent; of these, 57.00 percent showed excellent and regular compliance followed by nearly 30 percent good compliance. And 13.20 percent participants were non complaint to DOTS therapy. Positive Family behaviors were positively associated with compliance while alcohol consumption was found to be negatively associated with compliance however; age, sex and income were found to be non significant factors for compliance. Feeling of getting cure even before the course of DOTS therapy (feeling better after 2-3 months regular treatment) and drinking habits were found to be the major causes of non compliance. Supportive family behaviors and avoidance of alcohol consumption may promote the compliance. Excellent treatment compliance in the face of many odds is highly encouraging and the pattern can be useful in treatment despite little non compliances; furthermore compliance can be enhanced by acting on these causes of non compliances. Key words: Pulmonary, Tuberculosis, DOTS, Banke, Nepal

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Thin-layer agar (TL7H11) for rapid isolation of Mycobacterium tuberculosis in sputum specimens

Bangabandhu Sheikh Mujib Medical University Journal ◽

10.3329/bsmmuj.v7i1.29144 ◽

2016 ◽

Vol 7 (1) ◽

pp. 39

Author(s):

Habiba Binte Alam ◽

Md. Ruhul Amin Miah ◽

Mostofa Kamal ◽

Chandan Kumar Roy ◽

Ahmed Abu Saleh

Keyword(s):

Pulmonary Tuberculosis ◽

Thin Layer ◽

Infectious Agent ◽

Control Program ◽

Cross Sectional Study ◽

Sputum Smear ◽

Cross Sectional ◽

National Tuberculosis ◽

Lowenstein Jensen ◽

Mean Time

Background: Tuberculosis (TB) remains one of the major causes of death from a single infectious agent worldwide. The early detection of new cases of pulmonary tuberculosis is an important goal in tuberculosis control program.Objective: 1n this study, thin layer agar (TLA) culture was compared with Lowenstein-Jensen (LJ) culture for rapid detection of pulmonary tuberculosis. Methods: It was a cross sectional study conducted in National Tuberculosis Reference Laboratory (NTRL) of National Institute of Disease of Chest and Hospital (NIDCH), Dhaka, from July 2010 to June 2011. A total of 100 sputum smear positive for acid fast bacilli (AFB) by Z-N staining, pulmonary tuberculosis patients were included in this study. Samples were processed by modified Petroff method and then cultured on thin layer 7H11(TL7H11) plates and L-J tubes. TL7H11 plates were observed microscopically for rnicrocolony growth once a week for 6 weeks, and L-J tubes were observed once a week for 8 weeks. Results: The recovery rates of mycobacteria on only TLA, only LJ and on both media were 90%, 97% and 88% respectively. Overall positivity was 99% in both L-J and TLA media. Mean time for detection of mycobacteria on TLA was 9.04±1.66 days compared to 21.78±6.19 days on L-J media. The rate of contamination was higher (6%) in L-J media than in TLA media (4%). Conclusion: The TL7H11 media can be used as an alternative to the Lowenstein-Jensen medium for early isolation of mycobacteria in resource constrained settings.

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Assessment of physical conditions and current practice in laboratories carrying out sputum smear microscopy in Northwest Ethiopia

Tropical Doctor ◽

10.1258/004947505774938774 ◽

2005 ◽

Vol 35 (4) ◽

pp. 215-217 ◽

Cited By ~ 1

Author(s):

Andargachew Mulu ◽

Afework Kassu

Keyword(s):

Health Care ◽

Cross Sectional Study ◽

Northwest Ethiopia ◽

Sputum Smear ◽

Smear Microscopy ◽

Sputum Smear Microscopy ◽

Cross Sectional ◽

Safety Standards ◽

Physical Conditions ◽

Sputum Microscopy

A cross-sectional study was conducted in Northwestern Ethiopia involving 18 health-care institutes in August 2003 to assess the physical conditions and current laboratory practice, pertaining to handling sputum specimens in the health-care laboratories carrying out sputum smear microscopy. A structured and pre-tested questionnaire was used to collect information. The laboratories had an area of less than 25 m2. None of them had separate rooms or safety cabinets for sputum smear preparation. Only three laboratories used facemasks. QJ;Decontamination of sputum specimens prior to disposal was reported in only two. Incineration as a means of sputum specimen disposal was used in only six laboratories. The physical conditions of the laboratories were found below the standard set by the International Union Against Tuberculoses and Lung Diseases. A large number of sputum specimens continue to be handled, despite the poor conditions and procedures in all the healthcare laboratories. Laboratory safety standards need to be improved, to minimize the risk of infection. In addition, there is an urgent need for education, training and supervision of the staff involved in sputum microscopy.

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Predictive Role of ADA in Bronchoalveolar Lavage Fluid in Making the Diagnosis of Pulmonary Tuberculosis

Pulmonary Medicine ◽

10.1155/2013/851518 ◽

2013 ◽

Vol 2013 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Fariba Binesh ◽

Abolhassan Halvani

Keyword(s):

Bronchoalveolar Lavage ◽

Bronchoalveolar Lavage Fluid ◽

Study Groups ◽

Lavage Fluid ◽

Cross Sectional Study ◽

Sputum Smear ◽

Cross Sectional ◽

Pulmonary Tb ◽

Diagnostic Usefulness ◽

Negative Sputum

Current diagnostic tests for tuberculosis (TB) are time-consuming. The aim of this study was to evaluate the diagnostic usefulness of ADA in bronchoalveolar lavage fluid in patients with pulmonary TB. A cross-sectional study was performed in Yazd, Iran, between 2009 and 2010. Patients suspected of pulmonary TB with negative sputum smear for AFB were included in the study. Mean ADA levels in BAL fluids were measured and compared between study groups. Sixty-three patients were enrolled in the study among which 15 cases had pulmonary TB, 33 had pulmonary diseases other than TB, and 15 subjects with normal bronchoscopy results were considered as controls. Mean ADA levels in BAL fluid were4.13±2.55,2.42±1.06, and1.93±0.88, respectively. This rate was significantly higher in the pulmonary TB group compared to the other two groups (P=0.001). Using ROC curve with a cut-off value of 3.5 IU/L, the highest sensitivity (57%) and specificity (84%) were obtained in diagnosis of TB. The results showed that although ADA activity in BAL fluid of pulmonary TB patients was higher than those seen in other diseases, a negative test does not rule out pulmonary TB.

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SEROPREVALENCE OF HIV INFECTION IN PULMONARY TUBERCULOSIS PATIENTS.

10.36106/gjra/7900635 ◽

2020 ◽

pp. 1-3

Author(s):

K.G.R. Mallan ◽

A. Fathahudeen ◽

Manjula V.D.

Keyword(s):

Pulmonary Tuberculosis ◽

Tertiary Care ◽

Cross Sectional Study ◽

Sputum Smear ◽

Cross Sectional ◽

Tuberculosis Patients ◽

Pulmonary Tb ◽

Medical College ◽

Elimination Programme ◽

Kerala State

Aim : To Determine the seroprevalence of Human immunodeficiency virus infection among Pulmonary Tuberculosis patients in a tertiary care teaching institution, in Ernakulam district of Kerala state in India. Methods : Study was conducted in Respiratory medicine department and integrated counselling and testing centre (ICTC) of Government Medical College, Ernakulam With approval of IEC after getting written informed consent , a cross sectional study was conducted among 384 pulmonary TB patients who were registered under the National TB elimination Programme (RNTCP). Result :The prevalence of HIV among study population was 1.3 %. There was no gender difference while the highest age group less than 30 followed by 30-60. The major respiratory pathology among study subjects was consolidation (42.7%) followed by fibrosis(25.3%).Consolidation was a predominant presenting pathology seen in female pulmonary TB patients.The sensitivity of sputum smear against CBNAAT was 60.4% and specificity was 83%. Conclusion : The prevalence is low compared with the national average of 3 to 3.4 % HIV co infection among Tuberculosis patients during the study period.

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Utility of Bronchoalveolar Lavage in the Diagnosis of Sputum Negative Pulmonary Tuberculosis

Journal of Universal College of Medical Sciences ◽

10.3126/jucms.v8i1.29828 ◽

2020 ◽

Vol 8 (1) ◽

pp. 19-22

Author(s):

Subodh Sagar Dhakal ◽

Ashmita Neupane ◽

Shatdal Chaudhary ◽

Navin Mishra ◽

Damber Bdr Karki

Keyword(s):

Mycobacterium Tuberculosis ◽

Pulmonary Tuberculosis ◽

Bronchoalveolar Lavage ◽

Diagnostic Yield ◽

Cross Sectional Study ◽

Fibreoptic Bronchoscopy ◽

Sputum Smear ◽

Cross Sectional ◽

Acid Fast Bacilli ◽

Smear Negative

INTRODUCTION: Sputum smear examination for acid fast bacilli (AFB) by Ziehl-Neelsen stain (ZN stain) is the initial approach to the diagnosis of pulmonary tuberculosis (PTB). But 50% of the cases are reported to be sputum smear negative. This study was aimed to investigate the diagnostic yield of fibreoptic bronchoscopy (FOB) guided bronchoalveolar lavage (BAL) in patients suspected to have tuberculosis. The sample was tested for Mycobacterium tuberculosis using the XpertMTB/RIF assay, which is a new test that detects Mycobacterium tuberculosis complex and resistance to rifampin in less than two hours. MATERIAL AND METHODS: This is a prospective cross sectional study carried out on 58 sputum smear negative patients who were clinically suspected to have pulmonary tuberculosis from April 2017 to January 2019. All patients are subjected to FOB, BAL and BAL specimens were stained for AFB and also sent for Xpert (MTB)/RIF. RESULTS: Among 58 patients enrolled for the study 26 patients were positive for acid fast bacilli (AFB) through BAL stain and Xpert (MTB)/RIF combined. CONCLUSION: FOB guided BAL is a reliable, alternative and rapid method for diagnosing smear negative pulmonary tuberculosis with minimal complications.

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Pulmonary Tuberculosis among Male Inmates in the Largest Prison of Eastern Nepal

Tuberculosis Research and Treatment ◽

10.1155/2019/3176167 ◽

2019 ◽

Vol 2019 ◽

pp. 1-7

Author(s):

Gambhir Shrestha ◽

Deepak Kumar Yadav ◽

Rabin Gautam ◽

Rashmi Mulmi ◽

Dharanidhar Baral ◽

...

Keyword(s):

Pulmonary Tuberculosis ◽

Prison Population ◽

Cross Sectional Study ◽

High Rate ◽

Sputum Smear ◽

Cross Sectional ◽

Exact Test ◽

Abnormal Chest ◽

Chest Auscultation ◽

Male Inmates

Introduction. The prevalence of Pulmonary Tuberculosis (PTB) is much higher in the prison population than in the general population. This study aims to find out the prevalence of PTB and its associated factors among inmates in eastern Nepal. Methods. This cross-sectional study was conducted in Jhumka Regional Prison, the largest male prison of Eastern Nepal from September 2014 to August 2015. Semi-structured questionnaires were used to identify individuals with a cough more than one-week duration among 434 randomly selected inmates. Screening of PTB was done by sputum smear test and/or GeneXpert test. Prevalence of TB was defined as the number of cases detected during the study period divided by the total number of inmates screened during that period. Fisher’s exact test was used to find out the association of PTB with related variables. Results. A total of 434 inmates were screened for PTB with mean age 35.7 years and body mass index 22.7 kg/m2. A total of 68 inmates had a productive cough of more than a week and two patients were already on anti-tuberculosis therapy at the time of screening. Sixty sputum samples were considered for sputum smear/GeneXpert test and 6 of them (10%) had positive results. The prevalence of TB in the Prison was 1843/100,000 population. Chest pain and abnormal chest auscultation findings were found to be significantly associated with PTB. Conclusions. This study showed that there was a high rate of PTB among inmates in Nepal. The results suggest a need for effective screening of PTB and strategies to improve management including reduction of PTB transmission in the prison.

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Cavities Herald Persistent Sputum Positivity

10.21203/rs.3.rs-324393/v1 ◽

2021 ◽

Author(s):

Nadia Jawad ◽

Nausheen Saifullah ◽

Naseem Ahmed ◽

Saira Jafri

Keyword(s):

Pulmonary Tuberculosis ◽

Medical Center ◽

Tertiary Care ◽

National Policy ◽

Cross Sectional Study ◽

Tuberculosis Patient ◽

Sputum Smear ◽

Care Hospital ◽

Cross Sectional ◽

Directly Observed Treatment

Abstract Aim: To determine the factors associated with persistent sputum positivity at the end of two months of treatment in patients presenting with (drug-susceptible) pulmonary tuberculosis at a tertiary care hospital in Karachi.Setting: A cross-sectional study was conducted at the Department of Chest Medicine (Ward 12), Jinnah Postgraduate Medical Center (JPMC), Karachi over six months.Methods:A sample of 73 consenting, newly diagnosed, smear positive drug-susceptible pulmonary tuberculosis patients was studied. Demographic (age, gender, height, weight and duration of tuberculosis, body mass index (BMI), socioeconomic, occupational, marital, educational and residential statuses) and clinical factors (chest X-ray extent and cavities, initial smear results, diabetic and smoking statuses) which may be associated with sputum non-conversion were entered in a proforma. Patients were followed up at two months of treatment with a sputum smear. Data analysis was done on SPSS-20.0.Results:Rate of sputum positivity after two months of treatment was 17.8%. None of the factors was associated with persistence of sputum positivity except for the presence of chest radiograph (CXR) cavities; which made it 5.5 times more likely that the patient would remain smear-positive at two months (p=0.035).Conclusion:The finding of CXR cavities makes it highly likely that a pulmonary tuberculosis patient may remain infectious or have an unfavourable outcome despite taking treatment for 2 months. Clinicians and national policy-makers should thus bear in mind the implications this can have with regard to disease control and pay particular attention in terms of stringent monitoring and Directly Observed Treatment Short-course (DOTS) provision.

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