Rapid molecular test for tuberculosis: impact of its routine use at a referral hospital

ABSTRACT Objective: To evaluate the impact of the use of the molecular test for Mycobacterium tuberculosis and its resistance to rifampin (Xpert MTB/RIF), under routine conditions, at a referral hospital in the Brazilian state of Bahia. Methods: This was a descriptive study using the database of the Mycobacteriology Laboratory of the Octávio Mangabeira Specialized Hospital, in the city of Salvador, and georeferencing software. We evaluated 3,877 sputum samples collected from symptomatic respiratory patients, under routine conditions, between June of 2014 and March of 2015. All of the samples were submitted to sputum smear microscopy and the Xpert MTB/RIF test. Patients were stratified by gender, age, and geolocation. Results: Among the 3,877 sputum samples evaluated, the Xpert MTB/RIF test detected M. tuberculosis in 678 (17.5%), of which 60 (8.8%) showed resistance to rifampin. The Xpert MTB/RIF test detected M. tuberculosis in 254 patients who tested negative for sputum smear microscopy, thus increasing the diagnostic power by 59.9%. Conclusions: The use of the Xpert MTB/RIF test, under routine conditions, significantly increased the detection of cases of tuberculosis among sputum smear-negative patients.

Download Full-text

Tuberculosis: evaluation of the time between identification of symptoms and beginning of treatment

Revista Brasileira de Enfermagem ◽

10.1590/0034-7167-2018-0902 ◽

2020 ◽

Vol 73 (6) ◽

Author(s):

Lívia Félix de Oliveira ◽

Laura Maria Vidal Nogueira ◽

Ivaneide Leal Ataíde Rodrigues ◽

Pedro Fredemir Palha

Keyword(s):

Respiratory Symptoms ◽

Data Distribution ◽

Sputum Smear ◽

Smear Microscopy ◽

Time Interval ◽

Molecular Test ◽

Sputum Smear Microscopy ◽

Significance Level ◽

To Receive ◽

The City

ABSTRACT Objective: To analyze the time elapsed between the identification of respiratory symptoms and the beginning of tuberculosis treatment, considering the sputum smear microscopy and the RMT. Method: Descriptive, retrospective epidemiological study, carried out in two Health Units, which were the only units that performed diagnosis by sputum smear microscopy and Rapid Molecular Test in the city. Data on respiratory symptoms with a positive result for tuberculosis were used. Analysis of data distribution and variance was performed, with a significance level of 5%. Results: The longest time interval found was “result/beginning of treatment”, for both tests, with a median of 3 days. It was found that the patient takes longer to receive the result when performing the Rapid Molecular Test. Conclusion: Patients who had the Rapid Molecular Test waited longer for results when compared to sputum smear microscopy, leading to a reflection on the need for further studies on the operation of health services.

Download Full-text

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

10.20944/preprints201905.0225.v1 ◽

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.

Download Full-text

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

African Journal of Primary Health Care & Family Medicine ◽

10.4102/phcfm.v6i1.586 ◽

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.

Download Full-text

A Retrospective Cross-Sectional Study of the Utility of Cartridge-Based Nucleic Acid Amplification Test in Diagnosis of Pulmonary and Extrapulmonary Tuberculosis in People Living with HIV in Second Highest HIV Prevalent State in India

International Journal of Recent Surgical and Medical Sciences ◽

10.1055/s-0041-1730242 ◽

2021 ◽

Author(s):

Tade Bagbi ◽

Ningthoukhongjam Reema ◽

S. Bhagyabati Devi ◽

Thangjam Gautam Singh ◽

Mohammad Jaleel ◽

...

Keyword(s):

Nucleic Acid ◽

Cross Sectional Study ◽

Nucleic Acid Amplification Test ◽

Nucleic Acid Amplification ◽

Rifampicin Resistance ◽

Sputum Smear ◽

Smear Microscopy ◽

Sectional Study ◽

Cross Sectional ◽

Smear Negative

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

What a difference a day makes: same-day vs. 2-day sputum smear microscopy for diagnosing tuberculosis

Public Health Action ◽

10.5588/pha.16.0062 ◽

2016 ◽

Vol 6 (4) ◽

pp. 232-236 ◽

Cited By ~ 5

Author(s):

D. J. Deka ◽

B. Choudhury ◽

P. Talukdar ◽

T. Q. Lo ◽

B. Das ◽

...

Keyword(s):

Sputum Smear ◽

Smear Microscopy ◽

Sputum Smear Microscopy

Download Full-text

Ziehl–Neelsen sputum smear microscopy image database: a resource to facilitate automated bacilli detection for tuberculosis diagnosis

Journal of Medical Imaging ◽

10.1117/1.jmi.4.2.027503 ◽

2017 ◽

Vol 4 (2) ◽

pp. 027503 ◽

Cited By ~ 15

Author(s):

Mohammad Imran Shah ◽

Smriti Mishra ◽

Vinod Kumar Yadav ◽

Arun Chauhan ◽

Malay Sarkar ◽

...

Keyword(s):

Image Database ◽

Sputum Smear ◽

Smear Microscopy ◽

Sputum Smear Microscopy ◽

Microscopy Image ◽

Tuberculosis Diagnosis

Download Full-text

Clinical impact and cost analysis of the use of either the Xpert MTB Rif test or sputum smear microscopy in the diagnosis of pulmonary tuberculosis in Rio de Janeiro, Brazil

Revista da Sociedade Brasileira de Medicina Tropical ◽

10.1590/0037-8682-0082-2018 ◽

2018 ◽

Vol 51 (5) ◽

pp. 631-637

Author(s):

Anália Zuleika de Castro ◽

Adriana Rezende Moreira ◽

Jaqueline Oliveira ◽

Paulo Albuquerque Costa ◽

Carolyne Lalucha Alves Lima Da Graça ◽

...

Keyword(s):

Pulmonary Tuberculosis ◽

Cost Analysis ◽

Rio De Janeiro ◽

Clinical Impact ◽

Sputum Smear ◽

Smear Microscopy ◽

Sputum Smear Microscopy

Download Full-text

Factors associated with unfavorable outcome of tuberculosis treatment in people deprived of liberty: a systematic review

Revista da Escola de Enfermagem da USP ◽

10.1590/1980-220x-reeusp-2020-0583 ◽

2021 ◽

Vol 55 ◽

Author(s):

Nanci Michele Saita ◽

Rubia Laine de Paula Andrade ◽

Pedro Augusto Bossonario ◽

Rafaele Oliveira Bonfim ◽

Paula Hino ◽

...

Keyword(s):

Systematic Review ◽

Selection Process ◽

Data Extraction ◽

Previous History ◽

Unfavorable Outcome ◽

Tuberculosis Treatment ◽

Sputum Smear ◽

Smear Microscopy ◽

Sputum Smear Microscopy ◽

Factors Associated

ABSTRACT Objective: to analyze factors associated with unfavorable outcome of tuberculosis treatment in people deprived of liberty. Method: systematic review, carried out in March 2021 in seven databases, with no delimitation of period of publication. The selection process of publications and data extraction was carried out by two independent reviewers. Results: a total of 1,448 publications was identified and nine were included in the study. Unfavorable outcome was higher among those who were men; had low level of education; were living in a rural area before detention; had longer prison time; received occasional visits; had been transferred between prisons; with no sputum smear microscopy or with a positive result at the diagnosis; with no follow-up sputum smear microscopy, previous history of tuberculosis; having both clinical forms of the disease, HIV/AIDS; alcoholics; smokers; low body weight; and self-administered treatment. Treatment default was associated with young people and death with older people. Conclusion: prison health managers and professionals are expected to establish mechanisms of surveillance and health actions innovation aimed at the population deprived of liberty, making efforts to reduce the unfavorable outcomes of tuberculosis treatment.

Download Full-text