Comparison of different bacteriological testing strategies and factors for bacteriological confirmation among pulmonary TB patients: a retrospective study in Tianjin, China, 2017–2018

Abstract Background Bacteriological confirmation (BC) proportion among notified pulmonary TB patients in China is among the lowest in the world. This study was to understand the yield of BC using different testing strategies and patient-level factors associated with BC among pulmonary TB patients in Tianjin, China during 2017-2018.Methods A retrospective study was conducted, enrolling pulmonary TB patients reported to National TB Information Management System (TIMS) in Tianjin during 2017-2018. BC was defined as a positive result by any of the followings: smear microscopy, culture, or nucleic acid amplification test. Individual characteristics were compared between patients with positive and negative bacteriological results using contingency tables and c2 test. Multivariable logistic regression was applied to analyze factors associated with BC, calculating adjusted odds ratios (aOR) and 95% confidence intervals (CI) (α=0.05).Results Of 6,364 reported patients, 4,181 (65.7%) were bacteriologically confirmed. Positivity proportion was 43.1% (2,746/6,364) for smear microscopy, 57.7% (3,380/5,853) for culture, 61.7% (1,608/2,605) for Xpert® MTB/RIF assay (Xpert) and 73.4% (1,824/2,484) for combination of the three. The unemployed (aOR=1.5, 95% CI: 1.0-2.2) and farmers (aOR=1.7, 95% CI: 1.1-2.8) compared with students; diagnosis by inpatient hospitals compared with TB clinics (aOR=3.4, 95% CI: 2.6-4.4); having symptoms for ≥2 weeks (aOR=1.4, 95% CI: 1.1-1.8); cough (aOR=2.2, 95% CI: 1.8-2.8); blood sputum (aOR=1.5, 95% CI: 1.0-2.2); cavitation on chest X-ray (aOR=3.3, 95% CI: 2.5-4.3); bilateral lung lobes affected (aOR=1.7, 95% CI: 1.4-2.2) were factors associated with BC.Conclusions Combination tests was an effective way to improve BC among pulmonary TB patients. Being unemployed, farmers, having prolonged symptoms, and more severe in TB condition were factors associated with BC. We recommend combination of tests to improve BC for pulmonary TB patients, especially who are in early stage of the disease or with conditions tend to be bacteriologically negative.

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Comparison of different bacteriological testing strategies and factors for bacteriological confirmation among pulmonary TB patients: a retrospective study in Tianjin, China, 2017-2018

10.21203/rs.3.rs-32410/v1 ◽

2020 ◽

Author(s):

Guoqin Zhang ◽

Yuhua Zhang ◽

Mingting Chen ◽

Fan Zhang

Keyword(s):

Retrospective Study ◽

Early Stage ◽

Information Management System ◽

Individual Characteristics ◽

Nucleic Acid Amplification ◽

Smear Microscopy ◽

Pulmonary Tb ◽

Factors Associated ◽

Testing Strategies ◽

Bilateral Lung

Abstract Background Bacteriological confirmation rate among notified pulmonary TB patients in China is among the lowest in the world. This study was to understand the yield of bacteriological confirmation using different testing strategies and patient-level factors associated with bacteriological confirmation among pulmonary TB patients in Tianjin, China between 2017 and 2018. Methods A retrospective study was conducted, enrolling pulmonary TB patients reported to National TB Information Management System (TIMS) in Tianjin during 2017–2018. Bacteriological confirmation was defined as a positive result by any of the followings: smear microscopy, culture, or nucleic acid amplification test. Individual characteristics were compared between patients with positive and negative bacteriological results using contingency tables and χ2 test. Multivariable logistic regression was applied to analyze factors associated with bacteriological confirmation, calculating adjusted odds ratios (aOR) and 95% confidence intervals (CI) (α = 0.05). Results Of 6,364 reported patients, 4,181 (65.7%) were bacteriologically confirmed. Positivity proportion was 43.1% (2,746/6,364) for smear microscopy, 57.7% (3,380/5,853) for culture, 61.7% (1,608/2,605) for Xpert MTB/RIF and 73.4% (1,824/2,484) for combination of the three. Occupation as un-employed (aOR = 1.5, 95% CI: 1.0-2.2) and a farmer (aOR = 1.7, 95% CI: 1.1–2.8) compared with a student; diagnosis by inpatient hospitals compared with TB clinics (aOR = 3.4, 95% CI: 2.6–4.4); delay ≥ 2 weeks for TB care (aOR = 1.4, 95% CI: 1.1–1.8); cough (aOR = 2.2, 95% CI: 1.8–2.8); blood sputum (OR = 1.5, 95% CI: 1.0-2.2); cavitation on chest X-ray (OR = 3.3, 95% CI: 2.5–4.3); bilateral lung lobes affected (aOR = 1.7, 95% CI: 1.4–2.2) were factors associated with bacteriological confirmation. Conclusions Combination tests was an effective way to improve bacteriological confirmation among pulmonary TB patients. Being unemployed, farmers, delay for TB care, and more severe in TB condition were factors associated with bacteriological confirmation among the patients. We recommend combination of bacteriological tests and sputum collection intervention to improve bacteriological confirmation for pulmonary TB patients, especially who are in early stage of the disease or with conditions tend to be bacteriologically negative.

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Assessing testing strategies and duration of quarantine in contact tracing for SARS-CoV-2: a retrospective study of San Francisco’s COVID-19 contact tracing program, June- August, 2020

Open Forum Infectious Diseases ◽

10.1093/ofid/ofab171 ◽

2021 ◽

Author(s):

M J A Reid ◽

P Prado ◽

H Brosnan ◽

A Ernst ◽

H Spindler ◽

...

Keyword(s):

Retrospective Study ◽

San Francisco ◽

Contact Tracing ◽

Testing Strategies ◽

Close Contacts

Abstract We sought to assess the proportion of elicited close contacts diagnosed with COVID-19 at the start, and before exiting quarantine, in San Francisco, USA. From June 8th to August 31st, 6946 contacts were identified; 3008 (46.3%) tested, 940 (13.5%) tested positive; 90% tested positive in first 9 days of quarantine.

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Evaluation of risk factors for false-negative results with an antigen-specific peripheral blood-based quantitative T cell assay (T-SPOT®.TB) in the diagnosis of active tuberculosis: A large-scale retrospective study in China

Journal of International Medical Research ◽

10.1177/0300060518757381 ◽

2018 ◽

Vol 46 (5) ◽

pp. 1815-1825 ◽

Cited By ~ 7

Author(s):

Chi Yang ◽

Shaojun Zhang ◽

Lan Yao ◽

Lin Fan

Keyword(s):

Risk Factors ◽

Retrospective Study ◽

Respiratory Diseases ◽

False Negative ◽

False Negative Rate ◽

Active Tuberculosis ◽

Pulmonary Tb ◽

Negative Results ◽

False Negative Results ◽

Negative Sputum

Objective To investigate the diagnostic efficacy of an interferon-γ release assay, T-SPOT®. TB, for diagnosing active tuberculosis (TB) and to identify risk factors for false-negative results. Methods This retrospective study enrolled consecutive patients with active TB and with non-TB respiratory diseases to evaluate the risk factors for false-negative results when using the T-SPOT®. TB assay for the diagnosis of active TB. Patients with active TB were categorized as having confirmed pulmonary TB, clinically diagnosed pulmonary TB or extrapulmonary TB (EPTB). Results This study analysed 4964 consecutive patients; 2425 with active TB and 2539 with non-TB respiratory diseases. Multivariate logistic regression analyses identified the following five factors that were all associated with an increased false-negative rate with the T-SPOT®. TB assay: increased age (odds ratio [OR] 1.018; 95% confidence interval [CI] 1.013, 1.024); decreased CD8+ count (OR 0.307; 95% CI 0.117, 0.803); negative sputum acid-fast bacilli (AFB) smear staining (OR 1.821; 95% CI 1.338, 2.477); negative mycobacterial cultures (OR 1.379; 95% CI 1.043, 1.824); and absence of EPTB (OR 1.291; 95% CI 1.026, 1.623). Conclusions Increased age, decreased CD8+ count, negative sputum AFB smear results, negative sputum mycobacterial cultures and absence of EPTB might lead to an increased false-negative rate when using the T-SPOT®. TB assay.

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Tuberculosis among individuals with community-acquired pneumonia presenting to emergency in Gaborone, Botswana

Journal of Public Health in Africa ◽

10.4081/jphia.2018.803 ◽

2018 ◽

Cited By ~ 1

Author(s):

Jill K. Gersh ◽

Zachary Feldman ◽

Emily Greenberger ◽

Amit Chandra ◽

Harvey M. Friedman ◽

...

Keyword(s):

Emergency Department ◽

Retrospective Study ◽

Community Acquired Pneumonia ◽

Clinical Syndrome ◽

Hiv Positive ◽

Sputum Smear ◽

Clinical Factors ◽

Pulmonary Tb ◽

Factors Associated ◽

Logistic Regressions

Delays in diagnosing Tuberculosis (TB) are associated with increased transmission. TB may present as a clinical syndrome that mimics community-acquired pneumonia (CAP). The aim of this paper was to determine frequency of TB among patients with CAP at a referral hospital in Gaborone, Botswana. We performed a retrospective study of adults presenting with CAP from April 2010-October 2011 to the Emergency Department (ED); we matched this cohort to the National Botswana Tuberculosis Registry (NBTR) to identify individuals subsequently diagnosed with TB. We assessed demographics, time to TB diagnosis, clinical outcomes and performed logistic regressions to identify factors associated with TB diagnosis. We identified 1305 individuals presenting with CAP; TB was subsequently diagnosed in 68 (5.2%). The median time to TB diagnosis was 9.5 days. Forty percent were AFB sputum smear positive and 87% were identified as being HIV-positive. Subsequent diagnosis of TB is common among individuals with CAP at our ED, suggesting that TB may be present at the time of CAP presentation. Given the lack of distinguishing clinical factors between pulmonary TB and CAP, adults presenting with CAP should be evaluated for active TB in Botswana.

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Standardization and evaluation of a tetraplex polymerase chain reaction to detect and differentiate Mycobacterium tuberculosis complex and nontuberculous Mycobacteria—a retrospective study on pulmonary TB patients

Diagnostic Microbiology and Infectious Disease ◽

10.1016/j.diagmicrobio.2011.11.006 ◽

2012 ◽

Vol 72 (3) ◽

pp. 239-247 ◽

Cited By ~ 4

Author(s):

A.K. Anilkumar ◽

G.K. Madhavilatha ◽

Laiza K. Paul ◽

Indulakshmi Radhakrishnan ◽

R. Ajay Kumar ◽

...

Keyword(s):

Polymerase Chain Reaction ◽

Mycobacterium Tuberculosis ◽

Retrospective Study ◽

Mycobacterium Tuberculosis Complex ◽

Nontuberculous Mycobacteria ◽

Tuberculosis Complex ◽

Chain Reaction ◽

Pulmonary Tb ◽

Polymerase Chain

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Retrospective Analysis of 28 Cases of Tuberculosis in Pregnant Women in China

Scientific Reports ◽

10.1038/s41598-019-51695-8 ◽

2019 ◽

Vol 9 (1) ◽

Author(s):

Qiang Li ◽

Yanhua Song ◽

Hongmei Chen ◽

Li Xie ◽

Mengqiu Gao ◽

...

Keyword(s):

Retrospective Study ◽

Pregnant Women ◽

Categorical Variables ◽

Spontaneous Abortions ◽

Pulmonary Tb ◽

High Incidence ◽

Initial Onset ◽

Treatment Prognosis ◽

Timely Treatment ◽

Median Interval

Abstract While tuberculosis (TB) in pregnant women is reported globally, clinical data is unavailable in China. To describe clinical features and identify difficulties in the diagnosis of pregnancy-related TB, we performed a retrospective study of 28 TB inpatients at Beijing Chest Hospital. The results were presented in terms of interquartile range (IQR) for age, and medians and percentages with respect to the categorical variables. One patient (3.6%) was immediately diagnosed; for 27 patients (96.4%), the median interval from the initial onset of symptoms to diagnosis was five weeks. Eight cases (28.6%) were microbiologically confirmed. 22 (78.6%) were pulmonary TB (PTB), while six (21.4%) were extrapulmonary TB (EPTB). In addition, eight (28.6%) were miliary TB and six (21.4%) were cerebral TB. 27 (96.4%) were cured and one (3.6%) died. 15 neonates were identified, nine of which were healthy. Two were small for the gestational age (SGA) and one was a stillbirth. Three had neonatal TB, one of which died. Nine were legal abortions and four were spontaneous abortions. Indeed, there was a substantial delay in the diagnosis of TB in the pregnant women and a high incidence of both miliary and cerebral TB was evident. With timely treatment, prognosis is positive.

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Assessment of the Prevalence of Pulmonary Tuberculosis Patients at Nakfa Hospital from 2014-2019, Eritrea

10.1101/2020.02.11.20021279 ◽

2020 ◽

Author(s):

Yafet Kesete

Keyword(s):

Retrospective Study ◽

Pulmonary Tuberculosis ◽

Secondary Data ◽

Infectious Agent ◽

Age Group ◽

Pulmonary Tb ◽

Adult Age ◽

Control Programs ◽

Smear Positive Pulmonary Tuberculosis ◽

Tuberculosis Disease

AbstractBackgroundTuberculosis, an infectious disease, is one of the top 10 causes of death, and the leading cause from a single infectious agent M. tuberculosis. According to recent WHO estimate report, at least 3100 new TB cases occur every year in Eritrea. However, very little information is available in Eritrea related to area specific prevalence of tuberculosis and risk factors attributed to it. This is a retrospective study aimed to assess the prevalence of tuberculosis disease among patients attending at Nakfa Hospital, Eritrea.MethodsA retrospective study was conducted on patients visiting Nakfa Hospital, 221km north of Asmara, Eritrea from April 2014 to March 2019. Data was extracted from secondary data sources like patient admission records and laboratory registers at Nakfa Hospital.ResultsA total of 1100 patients were examined for tuberculosis using acid fast staining test. The overall prevalence of smear positive pulmonary TB cases was 7.8% (86 cases out of 1100). Females (8.2%) were more prone to have a positive Tuberculosis smear than males (7.4%). According to severity of infection, 38(3.5%) of subjects were +1 positive, whereas 23(2.1%) and 24(2.2%) of patients were +2 and +3 positives respectively. The highest prevalence of pulmonary TB was observed in the adult age group of 41-60 years (11%) and a comparatively higher number of cases was recorded in age group 21-40 years (8.3%). Adults aged between 41 to 60 had a two times more likelihood to be infected with Tuberculosis than those aged below 20 years old. Moreover, pulmonary tuberculosis was highly prevalent among middle age (20-60) than any other age class in all study years (2014-2019). The pulmonary TB cases were highly predominant during the year 2014 which was 16.8% (19 of 113 subjects) whereas the almost a quarter of it (4.5%) was recorded in following year. Based on locality, the highest rate of infection was observed in Adobha (25%), a town at border of Sudan and Eritrea, in which patients who came from Adobha had 4 times more likelihood to be infected than those from Nakfa town.ConclusionThis study showed Nakfa subzone has relatively increased prevalence of smear positive pulmonary tuberculosis than the average WHO estimate for the country. Therefore, appropriate policies and strategies for prevention, targeted detection of cases and treatment are required to reinforce Tuberculosis control programs.

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