Comparison of GeneXpert cycle threshold values with smear microscopy and culture as a measure of mycobacterial burden in five regional referral hospitals of Uganda- A cross-sectional study

Abstract Introduction Tuberculosis (TB) in people living with human immunodeficiency virus (PLHIV) is difficult to diagnose due to fewer organisms in sputum and extrapulmonary samples. Sputum culture takes 4 to 8 weeks for growth of the mycobacteria. Delayed treatment for TB in PLHIV leads to increased mortality. This study evaluated cartridge-based nucleic acid amplification test (CBNAAT) as a diagnostic tool for diagnosis of pulmonary TB (PTB) and extrapulmonary TB (EPTB) in PLHIV in the second most HIV prevalent state in India and for comparing its efficacy between Ziehl–Neelsen (ZN) staining sputum smear–positive and sputum smear–negative TB. Methods This cross-sectional study was conducted in RIMS, Imphal, with 167 PLHIV patients, age 15 years or older, having signs and symptoms of TB. Appropriate samples for sputum microscopy and CBNAAT were sent. Conclusion The overall sensitivity of sputum smear for acid-fast bacillus (AFB) was found to be 30.71% and that of CBNAAT was 38.57%. Sensitivity of CBNAAT for sputum smear–positive and sputum smear–negative TB was 100 and 11.3%, respectively. Sensitivity of ZN smear for AFB of EPTB sample was 48.1% and that of CBNAAT was 59.25%. In both PTB and EPTB, CBNAAT showed an increase in diagnosis of microbiologically confirmed PTB cases by 7.8 and 11.1%, respectively, over and above the cases diagnosed by ZN smear microscopy. Rifampicin resistance was detected in five patients. We conclude that CBNAAT is a rapid test with better sensitivity in diagnosis of PTB and EPTB in PLHIV, compared with ZN smear microscopy. It detects rifampicin resistance for multidrug-resistant TB and helps in early treatment intervention.

Download Full-text

Corrigendum to “Critical Incident Disclosing Behaviors and Associated Factors among Nurses Working in Amhara Region Referral Hospitals, Northwest Ethiopia: A Cross-Sectional Study”

Critical Care Research and Practice ◽

10.1155/2021/9842972 ◽

2021 ◽

Vol 2021 ◽

pp. 1-1

Author(s):

Yeshiambew Eshete ◽

Bekele Tesfaye ◽

Zewdu Dagnew ◽

Demewoz Kefale ◽

Demeke Mesfin Belay ◽

...

Keyword(s):

Critical Incident ◽

Associated Factors ◽

Cross Sectional Study ◽

Northwest Ethiopia ◽

Sectional Study ◽

Amhara Region ◽

Cross Sectional ◽

Referral Hospitals

Download Full-text

Diagnosis of tuberculosis from smear-negative presumptive TB cases using Xpert MTB/Rif assay: a cross-sectional study from Nepal

BMC Infectious Diseases ◽

10.1186/s12879-019-4728-2 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Priyatam Khadka ◽

Januka Thapaliya ◽

Ramesh Bahadur Basnet ◽

Gokarna Raj Ghimire ◽

Jyoti Amatya ◽

...

Keyword(s):

Previous History ◽

Clinical Information ◽

Cross Sectional Study ◽

University Teaching ◽

Molecular Diagnostic ◽

Smear Microscopy ◽

Sectional Study ◽

Cross Sectional ◽

Smear Negative ◽

Negative Sputum

Abstract Background In most developing countries, smear-negative pulmonary TB (SNPT) often gets missed from the diagnosis of consideration, though it accounts 30–65% of total PTB cases, due to deficient or inaccessible molecular diagnostic modalities. Methods The cross-sectional study enrolled 360 patients with clinical-radiological suspicion of SNPT in Tribhuvan University Teaching Hospital (TUTH). The patient selection was done as per the algorithm of Nepal’s National Tuberculosis Program (NTP) for Xpert MTB/RIF testing. Participants’ demographic and clinical information were collected using a pre-tested questionnaire. The specimens were collected, processed directly for Xpert MTB/RIF test according to the manufacturer’s protocol. The same samples were stained using the Ziehl-Neelsen technique then observed microscopically. Both findings were interpreted; rifampicin-resistant, if obtained, on Xpert testing was confirmed with a Line Probe Assay. Result Of 360 smear-negative sputum samples analyzed, 85(23.61%) found positive while 3(0.8%) of them were rifampicin resistance. The infection was higher in males, i.e. 60(25.3%) compared to female 25(20.3%). The age group, > 45(nearly 33%) with median age 42 ± 21.5, were prone to the infection. During the study period, 4.6% (515/11048) sputum samples were reported as smear-positive in TUTH. Consequently, with Xpert MTB/RIF assay, the additional case 16.5% (n = 85/515) from smear-negative presumptive TB cases were detected. Among the most occurring clinical presentations, cough and chest pain were positively associated with SNPT. While upper lobe infiltrates (36.4%) and pleural effusion (40.4%) were the most peculiar radiological impression noted in PTB patient. 94 multi-drug resistant(MDR) suspected cases were enrolled; of total suspects, 29(30.8%) samples were rifampicin sensitive, 1(1.06%) indeterminate, 3(3.19%) rifampicin-resistant while remaining of them were negative. 2(2.2%) MDR cases were recovered from the patient with a previous history of ATT, of total 89 previously treated cases enrolled However, a single rifampicin-resistant from the new suspects. Conclusion With an application of the assay, the additional cases, missed with smear microscopy, could be sought and exact incidence of the diseases could be revealed.

Download Full-text

Magnitude of maternal near misses and the role of delays in Ethiopia: a hospital based cross-sectional study

BMC Research Notes ◽

10.1186/s13104-019-4628-y ◽

2019 ◽

Vol 12 (1) ◽

Cited By ~ 2

Author(s):

Mulugeta Dile Worke ◽

Habtamu Demelash Enyew ◽

Maru Mekie Dagnew

Keyword(s):

Antenatal Care ◽

Health Care Access ◽

Cross Sectional Study ◽

Near Miss ◽

Sectional Study ◽

Cross Sectional ◽

Near Misses ◽

Care Access ◽

Referral Hospitals

Abstract Objectives This study was aimed to assess the magnitude of maternal near misses and the role of delays including other risk factors. A Hospital based cross sectional study was conducted at three referral hospitals of Amhara region on 572 mothers who came to obtain obstetrics care services from February 01 to July 30, 2018. Results The magnitude of maternal near miss was 26.6% (95% CI 23, 30). With regards to delays, 83 (14.5%), 226 (39.5%), and 154 (26.9%) of women delayed in the decision to seek care, in reaching care, and in receiving care respectively. Women who had no antenatal care [AOR = 3.16; CI (1.96, 5.10)], who stayed in hospital 7 days or more [AOR = 2.20; CI (1.33, 3.63)] and those who had delay in reaching health facility [AOR = 1.99; CI (1.10, 3.61)] were more likely to be near miss. While, women whose husband was able to read and write [AOR = 0.29; CI (0.09, 0.96)] and those with monthly household income between 2001 and 3000 ETB [AOR = 0.35; CI (0.18, 0.70)] were 71% and 65% less likely to be near misses respectively. Promoting antenatal care and increasing maternal health care access could have significant impact in reducing maternal near misses.

Download Full-text

Trends in misoprostol use and abortion complications: A cross-sectional study from nine referral hospitals in Nigeria

PLoS ONE ◽

10.1371/journal.pone.0209415 ◽

2018 ◽

Vol 13 (12) ◽

pp. e0209415 ◽

Cited By ~ 2

Author(s):

Folasade Adenike Bello ◽

Bukola Fawole ◽

Babawale Oluborode ◽

Ibraheem Awowole ◽

Theresa Irinyenikan ◽

...

Keyword(s):

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Abortion Complications ◽

Referral Hospitals

Download Full-text

Geographical variation in musculoskeletal surgical care in public hospitals in Ireland: a repeated cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2018-028037 ◽

2019 ◽

Vol 9 (5) ◽

pp. e028037 ◽

Cited By ~ 2

Author(s):

Mary E Walsh ◽

Fiona Boland ◽

John M O’Byrne ◽

Tom Fahey

Keyword(s):

Hip Fracture ◽

Hip Replacement ◽

Geographical Variation ◽

Private Health Insurance ◽

Knee Arthroscopy ◽

Cross Sectional Study ◽

Public Hospitals ◽

Sectional Study ◽

Cross Sectional ◽

Referral Hospitals

ObjectiveTo examine the extent of geographical variation across musculoskeletal surgical procedures and associated factors in Ireland.DesignRepeated cross-sectional study.Setting36 public hospitals in Ireland.ParticipantsAdult admissions for hip fracture, hip and knee replacement, knee arthroscopy and lumbar spine interventions over 5 years (2012–2016).Primary outcome measureStandardised discharge rate (SDR).AnalysisAge and sex SDRs were calculated for 21 geographical areas. Extremal quotients, coefficients of variation and systematic components of variance were calculated. Linear regression analyses were conducted exploring the relationship between SDRs and year, unemployment, % urban population, number of referral hospitals, % on waiting lists>6 months and % with private health insurance for each procedure.ResultsAcross 36 public hospitals, n=102 756 admissions were included. Hip fracture repair showed very low variation. Elective hip and knee procedures showed high variation in particular years, while variation for lumbar interventions was very high. Knee arthroscopy rates decreased over time. Higher unemployment was associated with knee and hip replacement rates and urban areas had lower hip replacement rates. Spinal procedure rates were associated with a lower number of referral hospitals in a region and spinal injection rates were associated with shorter waiting lists. A higher proportion of patients having private health insurance was associated with higher rates of hip and knee replacement and lumbar spinal procedures.ConclusionsVariation and factors associated with SDRs for publicly funded hip and knee procedures are consistent with similar international research in this field. Further research should explore reasons for high rates of spinal injections and the impact of private practice on musculoskeletal procedure variation.

Download Full-text

Undesirable Postoperative Anesthesia Outcomes at Two National Referral Hospitals: A Cross-Sectional Study in Eritrea

Anesthesiology Research and Practice ◽

10.1155/2020/9792170 ◽

2020 ◽

Vol 2020 ◽

pp. 1-8

Author(s):

Yonatan Mehari Andemeskel ◽

Traudl Elsholz ◽

Ghidey Gebreyohannes ◽

Eyasu H. Tesfamariam

Keyword(s):

Postoperative Pain ◽

Cross Sectional Study ◽

Care Patient ◽

Sectional Study ◽

Cross Sectional ◽

Patient Satisfaction Questionnaire ◽

Different Types ◽

Referral Hospitals ◽

Postoperative Problems ◽

Undesirable Outcome

Background. Postoperative undesirable anesthesia outcomes are common among patients undergoing surgery. They may affect body systems and lead into more serious postoperative problems. This research is conducted in the Eritrean National Referral Hospitals with the aim of assessing the prevalence of undesirable anesthesia outcomes during the postoperative period. Method. A cross-sectional study design was applied on 470 patients who underwent different types of surgeries within a three-month period. Patients were interviewed 24 hours after operation (POD 1) using the Leiden Perioperative care Patient Satisfaction questionnaire (LPPSq). This study reports one component of a large study conducted. The dimension “Discomfort and needs” of the LPPSq was considered, and the measurements of that dimension are presented in this report. Items of the dimension were standardized and measured using a five-point Likert scale from “Not at all” to “Extremely.” Multivariable logistic regression was used to look for the association of the outcomes with the types of surgery and types of anesthesia using SPSS (Version 22). Results. The prevalence were computed in two manners, prevalence of those with ‘at least a little bit’ outcomes, which was computed to see the total occurrence of these outcomes, and prevalence of those having ‘more than moderate’ outcomes to see the severe experience of these outcomes. Prevalence of the predominant undesirable outcome, postoperative pain, for ‘at least a little bit’ and ‘more than moderate’ were 82.6% and 43.6%, respectively. The rest of the postoperative undesirable outcomes were less frequently reported. Conclusion. Postoperative pain was found to be the most prevalent undesirable outcome. Enhancement of proper assessment and management of postoperative pain through the development and implementation of specific pain management modalities is needed.

Download Full-text