Sage Journals: Discover world-class research

Abstract

Pulmonary tuberculosis (PTB) is one of the top 10 causes of mortality worldwide in 2016. Early detection is very important, as it can help early treatment. This study compared 2 separate methods of diagnosing PTB among suspected patients, specifically examining correct diagnosis and the duration of receiving a correct diagnosis. It was carried out in a tertiary care public hospital in Bangkok, Thailand. Ninety patients were randomly assigned to 2 groups, one with the Xpert MTB/RIF (Mycobacterium tuberculosis/rifampicin) and the other with sputum AFB (acid-fast bacilli) smear. The proportion of correct diagnosis was 90.9% and 83.7% for the Xpert MTB/RIF and the comparison group, respectively. The difference was not statistically significant (P > .05). However, the time to correct diagnosis in the Xpert MTB/RIF group was significantly shorter than the comparison group (2.23 days). This could lead to early diagnosis and lower transmission rate of PTB cases. Results support the provision of Xpert MTB/RIF as the initial diagnostic test for PTB in Thailand.

Keywords

pulmonary tuberculosis time to get correct diagnosis Xpert MTB/RIF sputum AFB smear tertiary care hospital Thailand

Get full access to this article

View all access options for this article.

References

World Health Organization. Global tuberculosis report 2017. http://www.who.int/tb/publications/global_report/en/. Accessed April 17, 2018.

World Health Organization. Global tuberculosis report 2016. http://apps.who.int/medicinedocs/documents/s23098en/s23098en.pdf. Accessed June 11, 2017.

Nayak

Kumar

Claassens

et al . Comparing same day sputum microscopy with conventional sputum microscopy for the diagnosis of tuberculosis—Chhattisgarh, India. PLoS One. 2013;8:e74964.

Mao

Okada

Yamada

et al . Cross-sectional studies of tuberculosis prevalence in Cambodia between 2002 and 2011. Bull World Health Organ. 2014;92:573-581.

Mekonnen

Smear-positive pulmonary tuberculosis and AFB examination practices according to the standard checklist of WHO’s tuberculosis laboratory assessment tool in three governmental hospitals, Eastern Ethiopia. BMC Res Notes. 2014;7:295.

Diagnostic standards and classification of tuberculosis in adults and children. This official statement of the American Thoracic Society and the Centers for Disease Control and Prevention was adopted by the ATS Board of Directors, July 1999. This statement was endorsed by the Council of the Infectious Disease Society of America, September 1999. Am J Respir Crit Care Med. 2000;161(4 pt 1):1376-1395.

World Health Organization. Toman’s Tuberculosis Case Detection, Treatment, and Monitoring. 2nd ed. Geneva, Switzerland: World Health Organization; 2004.

World Health Organization. Global tuberculosis report 2014. http://apps.who.int/iris/handle/10665/137094. Accessed August 29, 2018.

Sreeramareddy

Qin

Satyanarayana

Subbaraman

Pai

Delays in diagnosis and treatment of pulmonary tuberculosis in India: a systematic review. Int J Tuberc Lung Dis. 2014;18:255-266.

10.

Cai

Wang

Han

Factors associated with patient and provider delays for tuberculosis diagnosis and treatment in Asia: a systematic review and meta-analysis. PLoS One. 2015;10:e0120088.

11.

Boehme

Nabeta

Hillemann

et al . Rapid molecular detection of tuberculosis and rifampin resistance. N Engl J Med. 2010;363:1005-1015.

12.

Bajrami

Mulliqi

Kurti

Lila

Raka

Comparison of GeneXpert MTB/RIF and conventional methods for the diagnosis of tuberculosis in Kosovo. J Infect Dev Ctries. 2016;10:418-422.

13.

Chang

Wang

et al . Rapid and effective diagnosis of tuberculosis and rifampicin resistance with Xpert MTB/RIF assay: a meta-analysis. J Infect. 2012;64:580-588.

14.

Pinyopornpanish

Chaiwarith

Pantip

et al . Comparison of Xpert MTB/RIF assay and the conventional sputum microscopy in detecting Mycobacterium tuberculosis in Northern Thailand. Tuberc Res Treat. 2015;2015:571782.

15.

Vassall

van Kampen

Sohn

et al . Rapid diagnosis of tuberculosis with the Xpert MTB/RIF assay in high burden countries: a cost-effectiveness analysis. PLoS Med. 2011;8:e1001120.

16.

World Health Organization. Xpert MTB/RIF Implementation Manual: Technical and Operational “How-to”; Practical Considerations. Saint-Marcel-lès-Valence, France: GPS Publishing; 2014.

17.

Steingart

Henry

et al . Fluorescence versus conventional sputum smear microscopy for tuberculosis: a systematic review. Lancet Infect Dis. 2006;6:570-581.

18.

Theron

Zijenah

Chanda

et al ; TB-NEAT Team. Feasibility, accuracy, and clinical effect of point-of-care Xpert MTB/RIF testing for tuberculosis in primary-care settings in Africa: a multicentre, randomised, controlled trial. Lancet. 2014;383:424-435.

19.

Steingart

Sohn

Schiller

et al . Xpert(R) MTB/RIF assay for pulmonary tuberculosis and rifampicin resistance in adults. Cochrane Database Syst Rev. 2013;(1):CD009593.

20.

Pezzotti

Pozzato

Ferroni

et al . Delay in diagnosis of pulmonary tuberculosis: a survey in the Lazio region, Italy. Epidemiol Biostat Public Health. 2015;12:1-10.

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB

0.34 MB

Effectiveness of Tuberculosis Screening Technology in the Initiation of Correct Diagnosis of Pulmonary Tuberculosis at a Tertiary Care Hospital in Thailand: Comparative Analysis of Xpert MTB/RIF Versus Sputum AFB Smear

Abstract

Keywords

Get full access to this article

References

Supplementary Material