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Duration of cough, TB suspects' characteristics and service factors determine the yield of smear microscopy

L Otero, R Ugaz, G Dieltiens, E Gonzalez, K Verdonck, C Seas, A Van Deun, E Gotuzzo and Patrick Van Der Stuyft UGent (2010) TROPICAL MEDICINE & INTERNATIONAL HEALTH. 15(12). p.1475-1480
abstract
OBJECTIVE To determine the efficiency of routine tuberculosis (TB) case detection by examining sputum smear positivity for acid-fast bacilli in relation to duration of cough, characteristics of TB suspects examined and health service factors. METHOD We combined patient interviews with routine data from laboratory registers in 6 health care facilities in San Juan de Lurigancho district, Lima, Peru. A TB case was defined as a TB suspect with at least one positive sputum smear. We calculated adjusted odds ratios with 95% confidence intervals for the association between smear positivity and health service and patient's characteristics. RESULTS Smear positivity was 7.3% (321/4376). Of the 4376 adults submitting sputa, 55.3% (2418) reported cough for <14 days. In this group, smear microscopy yielded 3.2% (78/2418) positive results vs. 12.4% (243/1958) in patients coughing for 14 or more days. Having cough for >2 weeks, being referred by health care staff, attending a secondary-level health care facility, male sex and age between 15 and 44 years were independent determinants of smear positivity. CONCLUSIONS Routine case detection yields a low proportion of smear-positive cases because of the inclusion of a high proportion of patients without cough or coughing for <2 weeks. Adherence to the national TB control programme guidelines on the selection of TB suspects would have a positive impact on the smear positivity rate, reduce laboratory costs and workload and possibly improve the reading quality of smear microscopy.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
PULMONARY TUBERCULOSIS, PREVALENCE, ACID-FAST BACILLI, smear positivity, Peru, cough, case detection, tuberculosis, STRATEGIES, COUNTRIES, SPUTUM, INDIA
journal title
TROPICAL MEDICINE & INTERNATIONAL HEALTH
Trop. Med. Int. Health
volume
15
issue
12
pages
1475 - 1480
Web of Science type
Article
Web of Science id
000284374600010
JCR category
TROPICAL MEDICINE
JCR impact factor
2.841 (2010)
JCR rank
3/19 (2010)
JCR quartile
1 (2010)
ISSN
1360-2276
DOI
10.1111/j.1365-3156.2010.02645.x
language
English
UGent publication?
no
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
1113825
handle
http://hdl.handle.net/1854/LU-1113825
date created
2011-02-01 14:22:51
date last changed
2016-12-19 15:46:02
@article{1113825,
  abstract     = {OBJECTIVE To determine the efficiency of routine tuberculosis (TB) case detection by examining sputum smear positivity for acid-fast bacilli in relation to duration of cough, characteristics of TB suspects examined and health service factors.
METHOD We combined patient interviews with routine data from laboratory registers in 6 health care facilities in San Juan de Lurigancho district, Lima, Peru. A TB case was defined as a TB suspect with at least one positive sputum smear. We calculated adjusted odds ratios with 95\% confidence intervals for the association between smear positivity and health service and patient's characteristics.
RESULTS Smear positivity was 7.3\% (321/4376). Of the 4376 adults submitting sputa, 55.3\% (2418) reported cough for {\textlangle}14 days. In this group, smear microscopy yielded 3.2\% (78/2418) positive results vs. 12.4\% (243/1958) in patients coughing for 14 or more days. Having cough for {\textrangle}2 weeks, being referred by health care staff, attending a secondary-level health care facility, male sex and age between 15 and 44 years were independent determinants of smear positivity.
CONCLUSIONS Routine case detection yields a low proportion of smear-positive cases because of the inclusion of a high proportion of patients without cough or coughing for {\textlangle}2 weeks. Adherence to the national TB control programme guidelines on the selection of TB suspects would have a positive impact on the smear positivity rate, reduce laboratory costs and workload and possibly improve the reading quality of smear microscopy.},
  author       = {Otero, L and Ugaz, R and Dieltiens, G and Gonzalez, E and Verdonck, K and Seas, C and Van Deun, A and Gotuzzo, E and Van Der Stuyft, Patrick},
  issn         = {1360-2276},
  journal      = {TROPICAL MEDICINE \& INTERNATIONAL HEALTH},
  keyword      = {PULMONARY TUBERCULOSIS,PREVALENCE,ACID-FAST BACILLI,smear positivity,Peru,cough,case detection,tuberculosis,STRATEGIES,COUNTRIES,SPUTUM,INDIA},
  language     = {eng},
  number       = {12},
  pages        = {1475--1480},
  title        = {Duration of cough, TB suspects' characteristics and service factors determine the yield of smear microscopy},
  url          = {http://dx.doi.org/10.1111/j.1365-3156.2010.02645.x},
  volume       = {15},
  year         = {2010},
}

Chicago
Otero, L, R Ugaz, G Dieltiens, E Gonzalez, K Verdonck, C Seas, A Van Deun, E Gotuzzo, and Patrick Van Der Stuyft. 2010. “Duration of Cough, TB Suspects’ Characteristics and Service Factors Determine the Yield of Smear Microscopy.” Tropical Medicine & International Health 15 (12): 1475–1480.
APA
Otero, L, Ugaz, R., Dieltiens, G., Gonzalez, E., Verdonck, K., Seas, C., Van Deun, A., et al. (2010). Duration of cough, TB suspects’ characteristics and service factors determine the yield of smear microscopy. TROPICAL MEDICINE & INTERNATIONAL HEALTH, 15(12), 1475–1480.
Vancouver
1.
Otero L, Ugaz R, Dieltiens G, Gonzalez E, Verdonck K, Seas C, et al. Duration of cough, TB suspects’ characteristics and service factors determine the yield of smear microscopy. TROPICAL MEDICINE & INTERNATIONAL HEALTH. 2010;15(12):1475–80.
MLA
Otero, L, R Ugaz, G Dieltiens, et al. “Duration of Cough, TB Suspects’ Characteristics and Service Factors Determine the Yield of Smear Microscopy.” TROPICAL MEDICINE & INTERNATIONAL HEALTH 15.12 (2010): 1475–1480. Print.