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

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 (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.

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

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.

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

2018 ◽  
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.

scholarly journals Use of Nucleic Acid Amplification Tests in Tuberculosis Patients in California, 2010–2013

2016 ◽  
Vol 3 (4) ◽  
Author(s):  
Gianna Peralta ◽  
Pennan Barry ◽  
Lisa Pascopella
Keyword(s):  
Nucleic Acid ◽  
Median Time ◽  
Treatment Initiation ◽  
The United States ◽  
Nucleic Acid Amplification ◽  
Smear Microscopy ◽  
Pulmonary Tb ◽  
Nucleic Acid Amplification Tests ◽  
Specimen Collection ◽  
Time To Treatment Initiation

Abstract Background Nucleic acid amplification tests (NAATs) have been used as a diagnostic tool for tuberculosis (TB) in the United States for many years. We sought to assess NAAT use in TB patients in California during a period of time when NAAT availability increased throughout the world. Methods We conducted a retrospective review of surveillance data from 6051 patients with culture-confirmed pulmonary TB who were reported to the California TB registry during 2010–2013. Results Only 2336 of 6051 (39%) TB patients had a NAAT for diagnosis before culture results. Although 90% (N = 2101) with NAAT had positive test results, 9% (N = 217) had falsely negative NAAT results, and 0.8% (N = 18) had indeterminate NAAT results. The median time from specimen collection to TB treatment initiation was shorter when NAAT was used (3 vs 14 days, P < .0001), and patients with a positive NAAT result initiated treatment earlier than patients with a falsely negative result (1 vs 11 days from NAAT report, P < .0001). We confirmed the increased sensitivity of NAAT compared with acid-fast bacilli (AFB) smear microscopy in our study population; 92 of 145 AFB smear-negative patients had positive NAATs. Median time from specimen collection to NAAT result report differed by health jurisdiction, from 1 to 11 working days. Conclusions Increased use of NAATs in diagnosis of pulmonary TB could decrease the time-to-treatment initiation and consequently decrease transmission. However, differential use and access to NAAT may prevent full realization of NAAT benefits in California.

scholarly journals Factors Associated with Initial Public School Reopening Plans During the US COVID-19 Pandemic: a Retrospective Study

2021 ◽  
Author(s):  
Brystana G. Kaufman ◽  
Nirosha Mahendraratnam ◽  
Thuy-vi Nguyen ◽  
Laura Benzing ◽  
Jessica Beliveau ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Public School ◽  
Factors Associated ◽  
The Us

scholarly journals 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

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.

scholarly journals 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

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.

scholarly journals To Swab or Not to Swab? The Lesson Learned in Italy in the Early Stage of the COVID-19 Pandemic

2021 ◽  
Vol 11 (9) ◽  
pp. 4042
Author(s):  
Paola Berchialla ◽  
Maria Teresa Giraudo ◽  
Carmen Fava ◽  
Andrea Ricotti ◽  
Giuseppe Saglio ◽  
...  
Keyword(s):  
Early Phase ◽  
Early Stage ◽  
Respiratory Illness ◽  
Explanatory Variables ◽  
Daily Number ◽  
Testing Strategies ◽  
Serious Infections ◽  
The Impact ◽  
Epidemiological Link ◽  
Severe Respiratory Illness

Testing for the SARS-CoV-2 infection is critical for tracking the spread of the virus and controlling the transmission dynamics. In the early phase of the pandemic in Italy, the decentralized healthcare system allowed regions to adopt different testing strategies. The objective of this paper is to assess the impact of the extensive testing of symptomatic individuals and their contacts on the number of hospitalizations against a more stringent testing strategy limited to suspected cases with severe respiratory illness and an epidemiological link to a COVID-19 case. A Poisson regression modelling approach was adopted. In the first model developed, the cumulative daily number of positive cases and a temporal trend were considered as explanatory variables. In the second, the cumulative daily number of swabs was further added. The explanatory variable, given by the number of swabs over time, explained most of the observed differences in the number of hospitalizations between the two strategies. The percentage of the expected error dropped from 70% of the first, simpler model to 15%. Increasing testing to detect and isolate infected individuals in the early phase of an outbreak improves the capability to reduce the spread of serious infections, lessening the burden of hospitals.

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