Characteristics of Patients with Smear-Negative Pulmonary Tuberculosis (TB) in a Region with High TB and HIV Prevalence

Abstract

IntroductionSmear-negative pulmonary TB (SNPT) represents 30–60% of all pulmonary TB cases. The mortality of these patients can reach 25% in populations with high prevalence of HIV infection, and 10–20% of TB transmission at the population level are attributable to SNPT cases.MethodsWe conducted a retrospective study to evaluate epidemiological, clinical, and radiological characteristics of patients with SNPT and to compare these with patients who were diagnosed as having smear-positive pulmonary TB (SPPT). All adult patients (≥ 18 years old) with a positive culture for Mycobacterium tuberculosis, and a diagnosis of pulmonary TB were included in the study.Results198 patients met the inclusion criteria (positive culture for Mycobacterium tuberculosis) and were included in the analysis. Of these patients, 69 (34.8%) were smear positive (SPPT) and 129 (65.2%) were smear negative (SNPT). In univariate analysis, cough, dyspnea, and hemoptysis were less frequent in SNPT patients in comparison with SPPT patients. In a multivariate model, having no cough and no radiographic pattern typical of TB were the characteristics independently associated with a diagnosis of SNPT.ConclusionsWe found a very high prevalence of SNPT among patients with TB in a setting with high TB and HIV prevalence. The absence of cough in the presence of other symptoms suggestive of TB, and having no radiographic pattern typical of TB where independent predictors of SNPT.

Nutritional status in sputum positive and sputum negative cases of pulmonary tuberculosis

“…[13,14] Few have found more prevalence of smear-negative cases as compared to smearpositive cases. [15] We did not find any statistically significant difference between the two groups with reference to their age, as also reported in other study. [15] Regarding symptoms, although all the symptoms were more common in SPPT patients than in SNPT group, it was not statistically significant except cough (P < 0.05).…”

“…[15] We did not find any statistically significant difference between the two groups with reference to their age, as also reported in other study. [15] Regarding symptoms, although all the symptoms were more common in SPPT patients than in SNPT group, it was not statistically significant except cough (P < 0.05). This may have been because of higher disease burden among smear-positive patients.…”

Sociodemographic and clinical characteristics of smear-positive and smear-negative pulmonary tuberculosis

“…Faktori rizika su zastupljeniji kod muškaraca nego kod žena, zaključeno je u istraživanju koje je obuhvatilo 14 zemalja sa najvećom stopom oboljevanja od TBC. Sputum negativna tuberkuloza pluća među obolelim na Severu Kosova bila je zastupljena u 35% slučajeva, što je u skladu sa rezultatima drugih studija [7,13]. Faktori rizika bili su jednako zastupljeni kod obolelih od sputum negativne i sputum pozitivne TBC.…”

“…Rana dijagnoza i tretman sputum pozitivne tuberkuloze (SPTBC) u osoba sa hroničnim kašljem je visoki prioritet za redukciju transmisije tuberkuloze [15]. Hemoptizije su češće kod obolelih od sputum pozitivne TBC, što je u korelaciji sa drugim studijama [13]. Noćno znojenje, povišena temperatura, i gubitak težine ne razlikuju se značajno kod ove dve grupe obolelih [13].…”

“…Hemoptizije su češće kod obolelih od sputum pozitivne TBC, što je u korelaciji sa drugim studijama [13]. Noćno znojenje, povišena temperatura, i gubitak težine ne razlikuju se značajno kod ove dve grupe obolelih [13].…”