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 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 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 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 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.

THE IMPORTANCE OF CHEST-X-RAY (TIMIKA SCORE) TO PREDICT THE CLINICO-BACTERIOLOGICAL PROFILE OF PULMONARY TUBERCULOSIS PATIENTS

2021 ◽  
pp. 55-58
Author(s):  
Surinder Pal Singh ◽  
Harjinder Singh ◽  
Komal Deep Kaur ◽  
Kailash Meena ◽  
Ashish Shukla ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Tertiary Care ◽  
Clinical Signs ◽  
Sputum Smear ◽  
Karnofsky Performance Score ◽  
Care Hospital ◽  
Duration Of Symptoms ◽  
Cavitary Lesion ◽  
X Ray ◽  
Chest X Ray

Introduction: Chest x-ray (CXR) is the primary modality for diagnosis and severity assessment and monitoring the ATT response in pulmonary tuberculosis (PTB). The aim of our study was to determine the correlation between the radiographic involvement of disease on CXR based on Timika CXR score with the clinically and bacteriological specications at diagnosis and initiation of ATT in sputum smear-positive PTB patients. Material And Method: A cross-sectional study was conducted in the Department of Pulmonary Medicine, a tertiary care hospital, Punjab, from January to June 2020. Seventy new sputum smear-positive cases of PTB were included. At the time of diagnosis, the patient's baseline test, clinical signs and symptoms were evaluated using TB scores I, II, Karnofsky performance score (KPS), and body mass index (BMI). Two chest physicians, according to the Timika CXR score, evaluated the CXR of each patient Independently. Result: Cavitary lesion on CXR resulted in a signicantly higher Timika score associated with higher Mycobacterial load in sputum grading compared to non-cavitary disease. 55.17% of patients with CXR score ≥71 had statistically signicant higher baseline sputum grading compared to 9.76% of patients with CXR ≤ 71. Higher Timika CXR score ≥ 71 was signicantly associated with a longer mean duration of symptoms, lower BMI, higher TB score, lower KPS at baseline, higher ESR, low hemoglobin, low serum albumin. Discussion: The study shows that Timika CXR score signicantly correlates with radiographic involvement and extent of disease severity on CXR with the clinically and bacteriological prole of PTB patients, which a pulmonologist can use in a medical practice. A Higher CXR Timika score is associated with the patient's poor clinical condition and the severity of the disease. Cavitary lesion on CXR associated with higher sputum smear grading. It is observed that the Timika CXR score can be used to identify the PTB patients at risk of treatment failure for their more aggressive management.

Pneumocystis jiroveci pneumonia and other pulmonary infections in TB smear-negative HIV-positive patients with atypical chest X-ray in Ethiopia

2007 ◽  
Vol 39 (11-12) ◽  
pp. 1045-1053 ◽  
Author(s):  
Getachew Aderaye ◽  
Judith Bruchfeld ◽  
Getachew Aseffa ◽  
Yared Nigussie ◽  
Kibrebeal Melaku ◽  
...  
Keyword(s):  
Hiv Positive ◽  
Pulmonary Infections ◽  
Pneumocystis Jiroveci ◽  
X Ray ◽  
Pneumocystis Jiroveci Pneumonia ◽  
Chest X Ray ◽  
Smear Negative

scholarly journals An observational report of universal GeneXpert testing of inpatients with diagnosed or presumptive TB in the Philippines

2020 ◽  
Vol 114 (9) ◽  
pp. 682-686
Author(s):  
Aye Myat Thi ◽  
Nathaniel Lee ◽  
Victoria Parris ◽  
Flora P Marin ◽  
Lynsil Roy ◽  
...  
Keyword(s):  
Scale Up ◽  
Multidrug Resistant ◽  
The Philippines ◽  
Rifampicin Resistance ◽  
X Ray ◽  
Tb Treatment ◽  
High Incidence ◽  
Chest X Ray ◽  
Smear Negative ◽  
Observational Report

Abstract Background The Philippines is a high TB and multidrug-resistant TB burden country. Although the scale-up of GeneXpert testing is occurring, the benefits of universal Xpert-Mycobacterium tuberculosis/ rifampicin (MTB/RIF) testing in inpatients have not been documented. Methods Routine GeneXpert testing irrespective of priority criteria for testing was conducted within a prospective cohort of all adults with known or presumptive TB admitted to a tertiary infectious diseases hospital in Manila. Study-specific TB diagnosis was decided upon bacteriological results, chest x-ray assessment, if already on anti-TB treatment (ATT) at admission and a cough duration of ≥2 wk. Results Of submitted sputum samples, 87.1% (277/318) had valid acid-fast bacilli (AFB) microscopy and Xpert® MTB/RIF results. Xpert® MTB/RIF was positive in 97.7% (n = 87/89) of AFB-positive patients and 25.5% (n = 48/188) of AFB-negative patients. Bacteriological confirmation in smear negative cases not on ATT prior to admission was 25.2% (34/135). Rifampicin resistance was detected in 26/135 Xpert positive cases (19.3%), including nine who might not otherwise have been detected, representing a 53% increase in yield. Conclusion Universal GeneXpert testing in this setting enhanced the yield of bacterial confirmation, revealing a high incidence of rifampicin resistance and suggesting a need for further investigations in Xpert-negative/smear-positive patients who may not have mycobacterial TB.

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