scholarly journals Chest X-rays in culture-negative pulmonary tuberculosis: early determination is superior to late determination

2020 ◽  
Vol 35 (5) ◽  
pp. 1072-1073
Author(s):  
Yong-Soo Kwon
Keyword(s):  
Pulmonary Tuberculosis ◽  
X Rays ◽  
Culture Negative

scholarly journals Evaluation of the performance of clinical predictors in estimating the probability of pulmonary tuberculosis among smear-negative cases in Northern Ethiopia: a cross-sectional study

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e037913
Author(s):  
Mala George ◽  
Geert-Jan Dinant ◽  
Efrem Kentiba ◽  
Teklu Teshome ◽  
Abinet Teshome ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Cross Sectional Study ◽  
Clinical Suspicion ◽  
Secondary Outcome ◽  
Northern Ethiopia ◽  
Sectional Study ◽  
Cross Sectional ◽  
Smear Negative ◽  
Culture Positive ◽  
Culture Negative

ObjectivesTo evaluate the performance of the predictors in estimating the probability of pulmonary tuberculosis (PTB) when all versus only significant variables are combined into a decision model (1) among all clinical suspects and (2) among smear-negative cases based on the results of culture tests.DesignA cross-sectional study.SettingTwo public referral hospitals in Tigray, Ethiopia.ParticipantsA total of 426 consecutive adult patients admitted to the hospitals with clinical suspicion of PTB were screened by sputum smear microscopy and chest radiograph (chest X-ray (CXR)) in accordance with the Ethiopian guidelines of the National Tuberculosis and Leprosy Program. Discontinuation of antituberculosis therapy in the past 3 months, unproductive cough, HIV positivity and unwillingness to give written informed consent were the basis of exclusion from the study.Primary and secondary outcome measuresA total of 354 patients were included in the final analysis, while 72 patients were excluded because culture tests were not done.ResultsThe strongest predictive variables of culture-positive PTB among patients with clinical suspicion were a positive smear test (OR 172; 95% CI 23.23 to 1273.54) and having CXR lesions compatible with PTB (OR 10.401; 95% CI 5.862 to 18.454). The regression model had a good predictive performance for identifying culture-positive PTB among patients with clinical suspicion (area under the curve (AUC) 0.84), but it was rather poor in patients with a negative smear result (AUC 0.64). Combining all the predictors in the model compared with only the independent significant variables did not really improve its performance to identify culture-positive (AUC 0.84–0.87) and culture-negative (AUC 0.64–0.69) PTB.ConclusionsOur finding suggests that predictive models based on clinical variables will not be useful to discriminate patients with culture-negative PTB from patients with culture-positive PTB among patients with smear-negative cases.

scholarly journals The epidemiology of pulmonary tuberculosis in children in Mainland China, 2009–2015

2019 ◽  
Vol 105 (4) ◽  
pp. 319-325 ◽  
Author(s):  
Ruling Yang ◽  
Mengyang Liu ◽  
Hui Jiang ◽  
Yingjie Zhang ◽  
Jinfeng Yin ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Age Groups ◽  
Mainland China ◽  
Information Management System ◽  
Care Seeking ◽  
X Rays ◽  
Effective Care ◽  
Control And Prevention ◽  
And Control ◽  
Epidemiological Characteristics

ObjectiveTo describe the incidence and epidemiological characteristics of child pulmonary tuberculosis (PTB) notified to the Chinese Center for Disease Control and Prevention (CDC) Tuberculosis Information Management System (TBIMS) from 2009 to 2015.Study designA database of child PTB for 31 provinces in mainland China over 7 years was retrospectively analysed. The spatiotemporal distribution of child PTB was described.ResultsIn total, 35,710 child PTB cases were notified to the TBIMS, representing only 0.60% of all 5,991,593 PTB case notifications. The average annual notified incidence of child PTB was 2.44/ per 100,000 children (95% CI: 1.77–3.10) and decreased by 52.53% in all age groups during the study period. Tibet had the highest incidence (15.95/ per 100,000 children), followed by Guizhou and Xinjiang. However, the case numbers were the most in Guizhou. The 0-1 year and 12–14 years of age groups exhibited the most cases. The positive rates of sputum smears, bacteriology and chest X-rays abnormality were 21.5%, 21.7% and 98.1%, respectively, which were lower than those 15 years of age and older (all p-values<0.0001).ConclusionThe notified incidence of child PTB in mainland China decreased substantially over 7 years. Future prevention and control of PTB in children should focus on the 0–1 and 12–14 years of age groups, and Tibet and Guizhou provinces. However, the notified incidence is still low, relative to adults, suggesting substantial under-reporting. Thus, more effective care seeking, identification and registration of children with TB are crucial.

scholarly journals Proportion of Patients Pulmonary Cancer With History of Slow Diagnosis Due to Diagnosis as Lung Tuberculosis

2019 ◽  
Vol 39 (2) ◽  
pp. 92-102
Author(s):  
Cut Yulia Indah Sari ◽  
Faisal Yunus ◽  
Elisna Sjahruddin
Keyword(s):  
Lung Cancer ◽  
Pulmonary Tuberculosis ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Diagnosis Delay ◽  
X Rays ◽  
Small Cell Lung ◽  
Study Objective ◽  
Pulmonary Tb

Background: In tuberculosis (TB) endemic countries, the diagnosis delay in lung cancer is due to initially misdiagnosed as pulmonary tuberculosis. The major concern that rose since early diagnosis of lung cancer could improve survival by tumor resectability chance and chemo-radiotherapy modality options. This study objective was to find out the proportion of lung cancer diagnosis delay due initially to misdiagnosed as pulmonary TB. Method: The cross-sectional study was held in Persahabatan Hospital and the subjects were histopatologically proven lung cancer patients between September 2012 to February 2013 involving totally 100 patients. The diagnosis delay were determined as whether the patients had been diagnosed as pulmonary tuberculosis and received anti-tuberculosis treatment (ATT) more than one month since current symptoms onset. All patients were interviewed and all chest X-rays were documented. Results: Fourty one of 100 patients were diagnosed as pulmonary TB and 29 of 41 patients received ATT more than one month. It consisted of 21 men and 8 women with the mean age of 51.5 years old. The cytology and histopatological biopsy revealed 28 Non Small Cell Lung Cancer (NSCLC) cases, and One Small Cell Lung Cancer (SCLC) case with all case were in end stage condition (6 cases in stage III and 22 cases in stage IV). Pre-referral sputum Acid Fast Bacilli (AFB) was conducted in only 9 cases with all negative results. Mean duration of ATT taken was 4.5±0.4 months. The ATT were given by 13 general practitioners, 12 pulmonologists and 4 internists. Discussion: Similar radiological findings in highly incidence of pulmonary TB could cause a large number of diagnosis delay in lung cancer due to initially diagnosed as pulmonary tuberculosis. Without proper investigation based on International Standard of TB Care, starting ATT with inadequate evaluation leads to diagnosis delay and lung cancer progression. (J Respir Indo 2019; 39(2))

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