scholarly journals High TB burden and low notification rates in the Philippines: The 2016 national TB prevalence survey

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0252240
Author(s):  
Mary Ann D. Lansang ◽  
Marissa M. Alejandria ◽  
Irwin Law ◽  
Noel R. Juban ◽  
Maria Lourdes E. Amarillo ◽  
...  
Keyword(s):  
Fluorescent Microscopy ◽  
The Philippines ◽  
Surveillance Data ◽  
Sputum Smear ◽  
Smear Microscopy ◽  
Pulmonary Tb ◽  
X Ray ◽  
Tb Control ◽  
Chest X Ray ◽  
Culture Positive

Setting The 3rd national tuberculosis (TB) survey in the Philippines in 2007 reported a significant decline in the prevalence of TB. Since then, more significant investments for TB control have been made, yet TB burden estimates from routine surveillance data remain relatively stable. Objective To estimate the prevalence of bacteriologically confirmed pulmonary TB in the Philippines amongst individuals aged ≥15 years in 2016. Design In March–December 2016, we conducted a population-based survey with stratified, multi-stage cluster sampling of residents in 106 clusters aged ≥15 years. Survey participants were screened for TB by symptom-based interview and digital chest X-ray. Those with cough ≥2 weeks and/or haemoptysis and/or chest X-ray suggestive of TB were requested to submit 2 sputum specimens for Xpert MTB/RIF, direct sputum smear microscopy using LED fluorescent microscopy, and mycobacterial solid culture (Ogawa method). Bacteriologically confirmed pulmonary TB was defined as MTB culture positive and/or Xpert positive. Results There were 46,689 individuals interviewed, and 41,444 (88.8%) consented to a chest X-ray. There were 18,597 (39.8%) eligible for sputum examination and 16,242 (87.3%) submitted at least one specimen. Out of 16,058 sputum-eligible participants, 183 (1.1%) were smear-positive. There were 466 bacteriologically confirmed TB cases: 238 (51.1%) Xpert positive, 69 (14.8%) culture positive, and 159 (34.1%) positive by both Xpert and culture. The estimated TB prevalence per 100,000 population aged ≥15 years was 434 (95% CI: 350−518) for smear-positive TB, and 1,159 (95% CI: 1,016−1,301) for bacteriologically confirmed TB. Conclusion This nationally representative survey found that the TB burden in the Philippines in 2016 was higher than estimated from routine TB surveillance data. There was no evidence of a decline in smear and culture positive TB from the 2007 survey despite significant investments in TB control. New strategies for case-finding and patient-centered care must be intensified and expanded.

scholarly journals Use of GeneXpert and the Role of an Expert Panel in Improving Clinical Diagnosis of Smear-Negative Tuberculosis Cases

2019 ◽  
Author(s):  
Jovilia Abong ◽  
Victoria Dalay ◽  
Ivor Langley ◽  
Ewan Tomeny ◽  
Danaida Marcelo ◽  
...  
Keyword(s):  
Expert Panel ◽  
Cross Sectional Study ◽  
The Philippines ◽  
Sputum Smear ◽  
Smear Microscopy ◽  
Cross Sectional ◽  
X Ray ◽  
Abnormal Chest ◽  
Smear Negative ◽  
The Impact

Setting A high proportion of notified tuberculosis cases in the Philippines are clinically diagnosed (63%) as opposed to bacteriologically confirmed. Better understanding of this phenomenon is required to improve tuberculosis control. Objectives To determine the percentage of Smear Negative Presumptive Tuberculosis patients that would be diagnosed by GeneXpert; compare clinical characteristics of patients diagnosed as tuberculosis cases; and review the impact that the current single government physician and a reconstituted Tuberculosis Diagnostic committee (Expert Panel) may have on tuberculosis over-diagnosis. Design This is a cross-sectional study of 152 patients 15-85 years old with two negative Direct Sputum Smear Microscopy results, with abnormal chest X-ray who underwent GeneXpert testing and review by an Expert Panel. Results 31% (48/152) of the sample were Xpert positive. 93% (97/104) of GeneXpert negatives were clinically diagnosed by a Single Physician. Typical symptoms and X-ray findings were higher in bacteriologically confirmed tuberculosis. When compared to GeneXpert results, the Expert panel’s sensitivity for active tuberculosis was high (97.5%, 39/40) but specificity was low (40.2%, 35/87). Conclusion Using the GeneXpert would increase the level of bacteriologically confirmed tuberculosis substantially among presumptive Tuberculosis. An Expert panel will greatly reduce over-diagnosis usually seen when a decision is made by a Single Physician.

scholarly journals Compliance of St Joseph’s Hospital Roma, Lesotho with the National Tuberculosis Programme of Lesotho, 2007 and 2008

2014 ◽  
Vol 6 (1) ◽  
Author(s):  
Oladoyinbo O. Samuel ◽  
Pierre J.T. De Villiers
Keyword(s):  
Treatment Failure ◽  
Sputum Smear ◽  
Smear Microscopy ◽  
Sputum Smear Microscopy ◽  
X Ray ◽  
National Tuberculosis Programme ◽  
National Tuberculosis ◽  
Tuberculosis Programme ◽  
Chest X Ray ◽  
Smear Negative

Background: In 2009 Lesotho had an estimated TB prevalence of 696 cases/100 000 population − the 4th highest in the world. This epidemic was characterised by high rates of death, treatment failure and unknown treatment outcomes. These adverse outcomes were attributable to a high rate of TB and/or HIV co-infection and weaknesses in the implementation of Lesotho’s National Tuberculosis Programme (NTP). This study was conducted in St Joseph’s Hospital, Roma (SJHR) to assess the implementation of the NTP.Method: Records of 993 patients entered into the SJHR TB register between 2007 and 2008 were reviewed. Patients’ treatment details were extracted from the register, validated and analysed by STATA 10.0.Results: Of 993 patients registered: 88% were new patients, 37% were diagnosed on sputum smear microscopy alone, 35% were diagnosed on sputum smear microscopy with chest X-ray, whilst 25% were diagnosed on chest X-ray alone. In addition: 33% were sputum smear positive, 45% were sputum smear negative, and 22% had extra-pulmonary TB. As to treatment outcome: 26% were cured, 51% completed treatment, and 51% converted from sputum smear positive to sputum smear negative over six months, whilst 16% died. Regarding HIV, 77% of patients were tested for HIV and 59% had TB and/or HIV co-infection. Of ten NTP targets only the defaulter and treatment failure rate targets were met.Conclusion: Whilst only two out of ten NTP targets were met at SJHR in 2007–2008, improvements in TB case management were noted in 2008 which were probably due to the positive effects of audit on staff performance.

scholarly journals PECULIARITIES OF CLINICAL AND X-RAY TANGULAR FORMS OF TUBERCULOSIS AND RESULTS OF ITS ETIOLOGICAL DIAGNOSTICS IN PATIENTS CONCERNED BY HIV+TB INFECTION IN THE REPUBLIC OF KARELIA

2018 ◽  
Vol 10 (3) ◽  
pp. 72-79
Author(s):  
E. V. Pahomova ◽  
Yu. M. Markelov ◽  
Т. V. Sunchalina ◽  
I. I. Rozhkova
Keyword(s):  
Multidrug Resistant ◽  
Sputum Smear ◽  
Smear Microscopy ◽  
Rapid Progression ◽  
Lethal Outcome ◽  
Pulmonary Tb ◽  
X Ray ◽  
Risk Of Death ◽  
The Republic ◽  
Etiologic Diagnosis

The purpose of this study was to study the clinical and radiological forms of TB in patients with HIV and the possibilities of etiologic diagnosis-the detection of MBT using various methods for determining and the effect of immunosuppression on the results of etiologic diagnosis. Materials and methods. The materials for the study were the analysis of clinical x-ray examination data and the results of etiological diagnosis of the Office in the Republic of Karelia for the period from 2001 to 2016 among 159 patients with a co-infection of HIV+TB in the bacteriological laboratory of the Republican TB Dispensary of the Karelia. Results of the research. The peculiarities of clinical and radiological forms of tuberculosis (TB) and infomativity of various methods of etiologic diagnosis of TB among 159 patients with combined HIV+TB infection for the period 2001–2016 in the Republic of Karelia were studied. It was revealed that the PCR diagnostics significantly reduced the likelihood of a lethal outcome of patients with a co-infection, as it allowed us to quickly identify not only the presence of the MBT, but also to identify MDR and appoint adequate chemotherapy on the first day of detection, which significantly reduced the risk of death. The frequency of bacterial excretion most often (69%) occurred in the group of patients with the most severe immunosuppression with an amount of CD4 cells less than 100 in 1 ml. It was found that among the patients with co-infection with HIV + pulmonary TB, cavities of disintegration in the lung tissue (38,5%) are significantly less likely to be detected, but bacteriovirus (68,5%) is detected more frequently than among patients with pulmonary TB in the territory of the Republic of Karelia (form 33). It has been established that improving the organization of sputum collection can significantly increase (at least 20%) the incidence of MBT in patients with pulmonary TB and HIV, which is important in the rapid diagnosis of TB and the appointment of adequate therapy, especially considering that among patients with co-infection 1⁄2 (52,8%) had MDR. The conclusion. For the timely diagnosis of pulmonary TB in HIV-infected patients, with frequent atypical clinical and radiological picture of TB and the possibility of rapid progression with lethal outcome, and also taking into account the results obtained (in 56% of patients with TB+HIV-MBT+), etiologic diagnosis of TB has priority value. The most affordable, cheap and epidemiologically significant method for detecting TB is sputum smear microscopy. The epidemiological danger was aggravated by the detection in 52,8% of patients with HIV+TB strains of multidrug-resistant and extensively drug-resistant MBT.

Hubungan antara Luas Lesi pada Foto Toraks Penderita TB Paru Dewasa yang Memiliki Riwayat Diabetes Melitus dengan Indeks Massa Tubuh di Rumah Sakit Hasan Sadikin Bandung

2016 ◽  
Vol 1 (3) ◽  
pp. 138-144
Author(s):  
Ina Edwina ◽  
Rista D Soetikno ◽  
Irma H Hikmat
Keyword(s):  
Chest Radiograph ◽  
Chi Square ◽  
Pulmonary Tb ◽  
X Ray ◽  
Consecutive Sampling ◽  
Close Relationship ◽  
Chi Square Test ◽  
Chest X Ray ◽  
The Relationship ◽  
Diabetes Melitus

Background: Tuberculosis (TB) and diabetes mellitus (DM) prevalence rates are increasing rapidly, especially in developing countries like Indonesia. There is a relationship between TB and DM that are very prominent, which is the prevalence of pulmonary TB with DM increased by 20 times compared with pulmonary TB without diabetes. Chest X-ray picture of TB patients with DM is atypical lesion. However, there are contradictories of pulmonary TB lesion on chest radiograph of DM patients. Nutritional status has a close relationship with the morbidity of DM, as well as TB.Objectives: The purpose of this study was to determine the relationship between the lesions of TB on the chest radiograph of patients who su?er from DM with their Body Mass Index (BMI) in Hasan Sadikin Hospital Bandung.Material and Methods: The study was conducted in Department of Radiology RSHS Bandung between October 2014 - February 2015. We did a consecutive sampling of chest radiograph and IMT of DM patients with clinical diagnosis of TB, then the data was analysed by Chi Square test to determine the relationship between degree of lesions on chest radiograph of pulmonary TB on patients who have DM with their BMI.Results: The results showed that adult patients with active pulmonary TB with DM mostly in the range of age 51-70 years old, equal to 62.22%, with the highest gender in men, equal to 60%. Chest radiograph of TB in patients with DM are mostly seen in people who are obese, which is 40% and the vast majority of lesions are minimal lesions that is equal to 40%.Conclusions: There is a signifcant association between pulmonary TB lesion degree with BMI, with p = 0.03

scholarly journals Sputum smear positivity grade and chest X-ray findings in tuberculosis: A cross-sectional study

2021 ◽  
Author(s):  
R. Behzadmehr ◽  
E. Nejadkehkha
Keyword(s):  
Cross Sectional Study ◽  
Health Concern ◽  
Sputum Smear ◽  
P Value ◽  
Sectional Study ◽  
Cross Sectional ◽  
Radiographic Findings ◽  
X Ray ◽  
High Prevalence ◽  
Chest X Ray

Despite many advances in the diagnosis, screening, and rapid treatment of tuberculosis, it is still a public health concern in the world. Due to the importance of this issue in diagnosis and reduction of transmission of infection and treatment of the disease especially where this study is conducted due to the high prevalence of tuberculosis, this study was done to determine The relationship between sputum smear positivity grade and chest X-ray findings in pulmonary tuberculosis patients in a hospital in southeast of Iran. This cross-sectional study was performed on all patients with pulmonary TB referencing the health centers in Zabol city, southeast of Iran from 1 January 2015 to 30 December 2020. Sputum smear and radiographic findings of the chest X-ray were evaluated. Data was collected using a form of information and finally analyzed by SPSS 22. Out of 101 patients examined in the present study, 71 were women and 30 were men. The mean age of the patients was 62.68 ± 13.61 years. The frequency of opacity in patients with grades 1, 2, and 3 was 71.4, 78.5, and 76.5%, respectively. Frequency of cavitation in patients with Grade 1, 2 and 3 was 11.5%, 28.5% and 52.9% respectively (P value 0.001). The frequency of reticulonodular presentations in patients with grade 1, 2, and 3 was 24.2, 7.1, and 0%, respectively.  In general, the results of this study showed that, with increasing grading of smears (1+, 2+, and 3+), the frequency of cavitation presentation increased significantly and the frequency of reticulonodular presentations decreased significantly. In general, the results of this study showed that, with increasing grading of smears (, the frequency of Cavitation presentation increased significantly and the frequency of reticulonodular presentations decreased significantly. The findings of the present study can help physicians better diagnose TB.

scholarly journals Comparison of Different Diagnostic Method for Mycobacteria Tuberculosis in Suspected Patients

1970 ◽  
Vol 7 (2) ◽  
pp. 84-88
Author(s):  
AR Khagi ◽  
S Singh ◽  
S Subba ◽  
A Bajracharya ◽  
R Tuladhar ◽  
...  
Keyword(s):  
Comparative Study ◽  
Sputum Smear ◽  
Study Group ◽  
Bacterial Cells ◽  
X Ray ◽  
Smear Examination ◽  
Group A ◽  
Chest X Ray ◽  
Group B ◽  
Sputum Smear Examination

Background: Microbial examination of smear of AFB by Z-N stain is currently the most rapid method for the detection of M. tuberculosis but its sensitivity is low i.e. required at least 10,000 bacterial cells per ml of sputum and also none specific, but auramine staining method has higher sensitivity than that of the Z-N stain but there are chances of false positive. Objective of this study was to find the correlation between chest X-ray, direct sputum smear examination by Ziehl-Neelsen stain, Auramine fluorochrome stain and sputum culture for M. tuberculosis. Methods: During that study period 250 x 3 samples were taken three each from 250 patients and divided into two groups A and B by performing Auramine fluorochrome stain in all samples . In group A, there were 150 fluorochrome stain positive samples. One each from 150 patient for comparative study of direct sputum smear examination by Ziehl-Neelsen stain, , culture on LJ medium and chest X-ray. Similarly in group B, next 100 fluorochrome stain negative specimens one each from 100 patients were taken for the comparative study of direct sputum smear examination by Ziehl-Neelsen stain, culture and chest X-ray. Results: In the study group A (n=150) all the specimens were positive in Auramine fluorochrome stain and all of them show positive in X-ray but only 134 showed positive in Ziehl-Neelsen stain and 136 showed positive in culture. In the study group B (n=100), all the specimens were negative in Auramine fluorochrome stain and all of them show negative in Ziehl-Neelsen stain but 14 of them were positive in culture and 24 were positive in chest X-ray. Conclusions: The diagnosis of PTB could be made by Auramine fluorochrome microscopy and culture. Key words: auramine fluorochrome stain; culture; mycobacterium tuberculosis; x-ray; ziehl-neelsen. DOI: 10.3126/jnhrc.v7i2.3012 Journal of Nepal Health Research Council Vol.7(2) Apr 2009 84-88

scholarly journals 1184. Making Pneumonia Surveillance Easy: Automation of Pneumonia Case Detection

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S424-S425
Author(s):  
Dan Ding ◽  
Anna Stachel ◽  
Eduardo Iturrate ◽  
Michael Phillips
Keyword(s):  
Language Processing ◽  
Cost Effective ◽  
The United States ◽  
Surveillance Data ◽  
X Rays ◽  
Healthcare Facilities ◽  
X Ray ◽  
Chest X Ray ◽  
Sensitivity Specificity ◽  
Time Critical

Abstract Background Pneumonia (PNU) is the second most common nosocomial infection in the United States and is associated with substantial morbidity and mortality. While definitions from CDC were developed to increase the reliability of surveillance data, reduce the burden of surveillance in healthcare facilities, and enhance the utility of surveillance data for improving patient safety - the algorithm is still laborious. We propose an implementation of a refined algorithm script which combines two CDC definitions with the use of natural language processing (NLP), a tool which relies on pattern matching to determine whether a condition of interest is reported as present or absent in a report, to automate PNU surveillance. Methods Using SAS v9.4 to write a query, we used a combination of National Healthcare Safety Network’s (NHSN) PNU and ventilator-associated event (VAE) definitions that use discrete fields found in electronic medical records (EMR) and trained an NLP tool to determine whether chest x-ray report was indicative of PNU (Fig1). To validate, we assessed sensitivity/specificity of NLP tool results compared with clinicians’ interpretations. Results The NLP tool was highly accurate in classifying the presence of PNU in chest x-rays. After training the NLP tool, there were only 4% discrepancies between NLP tool and clinicians interpretations of 223 x-ray reports - sensitivity 92.2% (81.1–97.8), specificity 97.1% (93.4–99.1), PPV 90.4% (79.0–96.8), NPV 97.7% (94.1–99.4). Combining the automated use of discrete EMR fields with NLP tool significantly reduces the time spent manually reviewing EMRs. A manual review for PNU without automation requires approximately 10 minutes each day per admission. With a monthly average of 2,350 adult admissions at our hospital and 16,170 patient-days for admissions with at least 2 days, the algorithm saves approximately 2,695 review hours. Conclusion The use of discrete EMR fields with an NLP tool proves to be a timelier, cost-effective yet accurate alternative to manual PNU surveillance review. By allowing an automated algorithm to review PNU, timely reports can be sent to units about individual cases. Compared with traditional CDC surveillance definitions, an automated tool allows real-time critical review for infection and prevention activities. Disclosures All authors: No reported disclosures.

Chest X-ray vs. Xpert® MTB/RIF assay for the diagnosis of sputum smear-negative tuberculosis in Uganda

2014 ◽  
Vol 18 (2) ◽  
pp. 216-219 ◽  
Author(s):  
C. Wekesa ◽  
B. J. Kirenga ◽  
M. L. Joloba ◽  
F. Bwanga ◽  
A. Katamba ◽  
...  
Keyword(s):  
Sputum Smear ◽  
X Ray ◽  
Chest X Ray ◽  
Smear Negative

scholarly journals Efficacy of gene xpert over other diagnostic modalities of tuberculosis among children

2019 ◽  
Vol 6 (4) ◽  
pp. 1545
Author(s):  
Deepmala Pandey ◽  
Ankur Yadav
Keyword(s):  
Age Groups ◽  
Sputum Smear ◽  
Smear Microscopy ◽  
Chi Square ◽  
Diagnostic Modality ◽  
Cross Sectional ◽  
Exact Test ◽  
Pulmonary Tb ◽  
Pediatric Age Group ◽  
Diagnostic Modalities

Background: Diagnosis of tuberculosis is a challenge especially among children. GeneXpert has been recommended as a diagnostic test in children. Objectives of this study was to efficacy of GeneXpert over other diagnostic modalities of Tuberculosis like Sputum smear microscopy, Mantoux testing, X-ray chest among children.Methods: A cross sectional hospital-based study was conducted over a period of 24 months among 150 children. All the patients who were having suspicion of Tuberculosis on the basis of History & Examination (fulfilling inclusion criteria) had been enrolled in the study. After doing all preliminary investigations clinical diagnosis has been made and Gene X’pert was carried out for all the samples collected. Pearson chi square test and Fishers exact test was applied wherever appropriate.Results: There was statistically no significant (p >0.05) difference of GeneXpert positivity within different age groups of Suspected TB patients. GeneXpert was positive in 80% with symptom of Cough lasting more than 2 weeks, in 78.8% with fever more than 2 weeks, in 88.9% with FTT, in 76.5% with H/O Koch’s contact, in 77.8% with H/O convulsion, in 69% with significant lymphadenopathy. GeneXpert was positive in all suspected TB patients having ZN staining positive for AFB. In clinically TB diagnosed patients, 86.5% were positive for GeneXpert.Conclusions: GeneXpert is a novel diagnostic modality of choice in all suspected Pulmonary & Extra-pulmonary TB cases among children. It can be used as a primary tool in Pulmonary TB with smear negative samples in pediatric age group.

scholarly journals Diagnostic bronchoscopy: an experience in a hospital of limited resources

2018 ◽  
Vol 6 (11) ◽  
pp. 3558
Author(s):  
Chingakham Debeshwar Singh ◽  
P. Wilubuibou ◽  
Thounaojam Amusana Singh
Keyword(s):  
Lung Cancer ◽  
Nucleic Acid Amplification ◽  
Limited Resources ◽  
Sputum Smear ◽  
X Ray ◽  
Medical College ◽  
Diagnostic Bronchoscopy ◽  
Chest X Ray ◽  
Set Up ◽  
Diagnosis Of Lung Cancer

Background: Diagnostic bronchoscopy is conventionally performed in evaluating undiagnosed abnormal chest x-ray findings, undiagnosed haemoptysis, pleural effusion, unexplained cough and collapse of lung etc. One indispensable use currently is for diagnosis of lung cancer. The aim of the study was to study the various types of patients who have undergone Diagnostic Bronchoscopy in a hospital of limited resources and the diagnostic outcomes of the procedures.Methods: A retrospective study of Bronchoscopies was done from October 2016 to January 2018, in Department of Respiratory Medicine in the hospital of a Medical College. All 178 patients of all age and any sex were included in the study. These patients present in the study had chest X-ray and CT scan of thorax. Other investigations done were ZN stains for AFB and CBNAAT-TB (Cartridge Based Nucleic Acid Amplification Test) for sputum and blood complete haemogram, prior to bronchoscopy.Results: Our study has shown that Diagnostic bronchoscopy is particularly useful in diagnosis of lung cancer, sputum smear negative Tuberculosis, if proper selection of cases is done even in a centre of limited resources. It has become an absolute necessity in a medical college hospital.Conclusions: Bronchoscopy in our resource limited set up shows that it is an indispensable tool for diagnosis of lung cancer with patients with clinical presentations of lung collapse, unresolved consolidation, lung masses, undiagnosed pleural effusions and haemoptysis. The usefulness can be much better if facilities like TBNA, EBUS are made available.

Sign in / Sign up

Export Citation Format

Share Document