Diagnoses from lung specimen collected through flexible bronchoscopy from patients in a tertiary hospital in Dar es Salaam Tanzania: a retrospective cross-sectional study

Ndilanha, Deus A.; Shayo, Grace A.; Hassan, Ramadhan; Byomuganyizi, Moses; Lema, L. E. K.

doi:10.1186/s12890-019-0972-x

Cited by 12 publications

(15 citation statements)

References 20 publications

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“…There was a wide variation in the indication for flexible bronchoscopy which we grouped into four main categories for easy analysis. Suspected malignancy and infection were the most common indications for bronchoscopy accounting for 75% of all cases, this finding is also consistent with other reports [ 4 , 7 , 9 , 18 ]. We however performed flexible bronchoscopy in 4 patients after chest trauma to assess the airway before thoracotomy.…”

Section: Discussionsupporting

confidence: 92%

“…Over 60% of the cases were male with a mean age of 44 years. Male predominance is also reported in some of the literatures [ 4 , 7 , 18 ]. Our study included children, hence the relatively younger mean age observed for bronchoscopy.…”

Section: Discussionmentioning

confidence: 56%

“…However, this increase is still limited in comparison to advanced countries due probably to the lack of the disease awareness, availability of diagnostic capabilities and infrastructure including CT scan, flexible bronchoscopy, pathological services and patient´s affordability. Financial constraints has always being of concern in the subregion when it comes to infrastructure development and accessibility of patients as previously reported [ 4 , 6 , 22 , 23 ]. In-hospital ward referrals were usually done when patient is not responding to initial treatment or presents with complications.…”

Section: Discussionmentioning

confidence: 99%

“…The most commonly diagnosed condition in our patients was cancer of the lungs. There seem to be an increasing trend of lung cancer diagnosed by flexible bronchoscopy in the sub-Saharan African region [ 4 , 7 , 9 , 18 - 20 ]. However, this increase is still limited in comparison to advanced countries due probably to the lack of the disease awareness, availability of diagnostic capabilities and infrastructure including CT scan, flexible bronchoscopy, pathological services and patient´s affordability.…”

Section: Discussionmentioning

confidence: 99%

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Flexible bronchoscopy in Ghana: initial experience in a tertiary hospital

Issaka¹,

Adjeso²,

Yabasin³

2021

Pan Afr Med J

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Introduction the use of flexible bronchoscopy in developing countries is limited. We report our initial experience and outcome with the use of flexible bronchoscopy at the Tamale Teaching Hospital in Ghana. This is the first reported case series of flexible bronchoscopy in Ghana. Methods a retrospective review of patients who had flexible bronchoscopy from 2017-2019 was analyzed. Patient demographics and outcomes were summarized using frequency distribution and percentages. Results we performed flexible bronchoscopies in 33 patients with mean age of 43 years. All patients were symptomatic at the time of presentation with the most common symptoms being chest pain (63.6%), dyspnea (57.6%) and cough (48.5%). The indication for bronchoscopy in most of the cases were suspected malignancy in 16 (48.5%) followed by infection 9 (27.3%), trauma 4 (12.1%) and others 4 (12.1%). We observed abnormal bronchoscopic findings in 25 (75.8%) of the cases with most of the pathologies in the right main bronchus. Twelve patients had toilet bronchoscopy, 6 had biopsy, 5 had no intervention and 4 patients had bronchoalveolar lavage (BAL). Culture and sensitivity results were available for 11 patients, of which 7 patients had negative results. Thirteen (13) malignancies and 11 inflammatory/infectious diseases were diagnosed in this case series. The mean procedure time was 32 minutes with mean hospital stay of 7 days. There was no complication or mortality in our series. Conclusion: flexible bronchoscopy is a safe procedure and indispensable in Ghana where there is an increasing incidence of lung diseases.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 56%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Flexible bronchoscopy in Ghana: initial experience in a tertiary hospital

Issaka¹,

Adjeso²,

Yabasin³

2021

Pan Afr Med J

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“…In this study, mycobacterial infections, including TB and NTM, were the most prevalent infectious disease diagnosed, in 4 (16.7%) and 12 (50.0%) patients, respectively. A recent study from Tanzania reported a similar prevalence of TB in patients undergoing bronchoscopy 9 . As Japan is known to be an intermediate TB‐burden 3 and a high NTM‐burden country (incidence of 12.3 per 100,000 population in 2018), 10,11 our findings indicate the need to use a fit‐tested N95 particulate respirator or higher‐grade respiratory precautions to prevent occupational exposure to TB from patients with suspected malignancy during routine bronchoscopy.…”

Section: Discussionsupporting

confidence: 61%

Pulmonary infections mimicking malignancy on bronchoscopy: A retrospective single‐center study in Japan

Shimizu

Murakami

Hida

2020

J of Gen and Family Med

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BackgroundPulmonary infections can imitate pulmonary neoplasms. Pulmonary tuberculosis (TB) is a typical example of an infection that mimics cancer and results in unexpected exposure of healthcare workers to TB. A large number of patients with suspected lung malignancy are referred to cancer centers, although the epidemiology of the final diagnosis is unclear in Japan. This study aimed to determine the frequency and nature of pulmonary infections that imitate malignancy among patients with presumed lung cancer that is subsequently diagnosed as a pulmonary infection based on bronchoscopy findings. We also aimed to identify the prevalence of formerly undiagnosed pulmonary tuberculosis that could pose an occupational risk to healthcare workers.MethodsThis single‐center retrospective cross‐sectional study included patients with suspected pulmonary malignancy who underwent bronchoscopy at a tertiary care cancer center in Japan between April 2017 and March 2020. Electronic medical records of the bronchoscopy database were reviewed to identify the final diagnoses recorded by physicians.ResultsAmong the 460 patients enrolled in the present study, 362 (78.7%) and 8 (1.7%) had primary or metastatic pulmonary lesions and benign lesions, respectively. Sixty‐six patients (14.3%) had nonspecific findings or other pulmonary diseases. Infection was confirmed in 24 patients (5.2%). Mycobacterial infections (n = 16) were the most frequent infectious disease; four patients had TB and 12 had nontuberculous mycobacterial infections.ConclusionsDespite the rare occurrence of TB in patients with suspected lung malignancy, healthcare workers should remain vigilant regarding the possibility of TB to prevent occupational exposure during invasive procedures such as routine bronchoscopy.

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Safety and Effectiveness of Transthoracic Core Needle Biopsy in a Newly Established Interventional Radiology Program in Tanzania

Mbuguje

Alswang

Rukundo

et al. 2021

The Arab Journal of Interventional Radiology

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Background Transthoracic core needle biopsy (TTCNB) became a routinely offered procedure in Tanzania in October 2018. This study evaluates the safety and effectiveness of establishing a TTCNB program in a resource-limited setting. Methodology A single center, prospective, observational cohort study was conducted at Muhimbili National Hospital on 90 patients who underwent computed tomography-guided TTCNB from October 2018 to May 2021. Patient and procedural data, including demographic information, complications, pathology results, and clinical outcomes, were stored in a Research Electronic Data Capture (REDCap) database. Follow-up was conducted at 4 weeks postprocedure by phone. Descriptive analysis was performed using Statistical Package for Social Sciences. Results A total of 90 patients underwent TTCNB. Seven samples were lost or never processed. In total, 68/83 (81.9%) of processed samples were diagnostic, with 89.7% (n = 61) classified as malignant and 10.3% (n = 7) classified as benign. Overall, 82.4% (n = 56) were classified as primary malignancies, 7.4% (n = 5) as metastatic malignancies, 5.9% (n = 4) as benign tumors, and 4.4% (n = 3) as infectious. Reasons for nondiagnostic samples were crashed/insufficient samples in 53.3% (n = 8) and nonspecific chronic inflammation in 46.7% (n = 7). Minor (Society of Interventional Radiology [SIR] class A and B) complications occurred in 8 cases (8.9%), while there was 1 (1.1%) major complication (SIR class F). A total of 44/90 (48.9%) patients could be reached for follow-up at 4 weeks postprocedure. In addition, 31/44 (70.5%) of these patients had a diagnosis of malignancy. Of these, 20 received chemotherapy, 8 died prior to receiving any treatment, 2 declined any further medical or surgical intervention, and 1 was treated with surgical excision and adjuvant chemotherapy. Conclusion Although recently introduced in Tanzania, TTCNB has been performed with 81.9% diagnostic accuracy and a complication rate comparable to existing literature.

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Diagnoses from lung specimen collected through flexible bronchoscopy from patients in a tertiary hospital in Dar es Salaam Tanzania: a retrospective cross-sectional study

Cited by 12 publications

References 20 publications

Flexible bronchoscopy in Ghana: initial experience in a tertiary hospital

Flexible bronchoscopy in Ghana: initial experience in a tertiary hospital

Pulmonary infections mimicking malignancy on bronchoscopy: A retrospective single‐center study in Japan

Safety and Effectiveness of Transthoracic Core Needle Biopsy in a Newly Established Interventional Radiology Program in Tanzania

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