Diagnostic implications and inpatient mortality related to tuberculosis at Jimma Medical Center, southwest Ethiopia

Kebede, Wakjira; Gudina, Esayas Kebede; Balay, G.; Abebe, Gemeda

doi:10.1016/j.jctube.2021.100220

Cited by 3 publications

(4 citation statements)

References 19 publications

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“…Other studies in Malawi and Zimbabwe reported mortality rates of 23% and 22%, respectively [41,42]. A review by Kebede et al [43] in Ethiopia also had a lower mortality rate of 24.5% in a hospital-based review of TB cases. Comparatively, the later study had a lower HIV population of 27% with only 18% of them diagnosed with EPTB while our cohort had 34% HIV cases with 49% of them diagnosed with EPTB.…”

Section: Discussionmentioning

confidence: 84%

The Burden of Bacteriologically Negative TB Diagnosis: A Four-Year Review of Tuberculosis Cases at a Tertiary Facility

Afriyie-Mensah,

Aryee,

Zigah

et al. 2023

Tuberculosis Research and Treatment

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Aim. We aimed to investigate the demographic and clinical factors associated with TB mortality in patients managed at a tertiary TB referral center. Methods. We conducted a retrospective review of the medical records of 1,933 TB patients seen between January 2017 and December 2020 at the Korle-Bu Teaching Hospital (KBTH) Chest Department in Accra, Ghana. TB mortality was defined as any TB patient who died for any reason during the course of treatment. Multivariable logistic regression was used to estimate adjusted odds ratios with 95% confidence intervals for factors associated with TB mortality. Results. A total of 1,933 patients with TB were registered at the chest clinic over the study period. Males accounted for 1,227 (63.5%), and majority of participants were between 24 and 64 years old. Pulmonary TB (PTB) and extrapulmonary TB (EPTB) cases accounted for 51% and 48.4% of the total TB cases, respectively. A significant proportion (69%) of the patients managed for TB had no bacteriological confirmation of the disease. About 34% of tested TB patients were HIV positive. Mortality among patients was 33.6%. In a multivariable regression model, patients with HIV positive status had over 3-fold increased risk of mortality, compared to those with HIV negative status. TB patients diagnosed empirically had an increased risk of death compared to those with a confirmed diagnosis. Conclusion. The proportion of clinically diagnosed TB was high among the patients seen at the chest clinic. Mortality was high among the patients with HIV/TB coinfection as well as in patients with empirical TB diagnosis.

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Section: Discussionmentioning

confidence: 84%

The Burden of Bacteriologically Negative TB Diagnosis: A Four-Year Review of Tuberculosis Cases at a Tertiary Facility

Afriyie-Mensah,

Aryee,

Zigah

et al. 2023

Tuberculosis Research and Treatment

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“…We obtained a mortality rate of 10.2%, but in different studies [ 17 ], it varies greatly [ 18 ]. There is no significant difference in terms of mortality between those who receive the diagnosis during admission or before admission.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis and Management of Adult Tuberculosis Patients Admitted to a Rural Hospital in Ethiopia

Comeche¹,

Pérez-Butragueño²,

Górgolas³

et al. 2023

Cureus

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BackgroundEthiopia is one of the countries in the world with the highest rate of tuberculosis (TB). The aim of this study is to describe the characteristics of the patients with TB admitted to a rural hospital in Ethiopia in terms of both diagnosis and clinical management. MethodsA retrospective descriptive observational study was conducted. Data were collected from patients older than 13 years who were admitted to the Gambo General Hospital for TB between May 2016 and September 2017. The variables studied were age, sex, symptoms, human immunodeficiency virus (HIV) serology, nutritional status, presence of anemia, chest x-ray or other complementary tests, type of diagnosis (smear microscopy, Xpert MTB-RIF (Cepheid, Sunnyvale, California, USA), or clinical diagnosis), treatment received, outcome, and days of admission. ResultsOne hundred eighty-six patients, aged 13 years and older, were admitted to the TB unit. About 51.6% were female, and the median age was 35 years (interquartile range (IQR) 25-50). Cough was the most frequent symptom on admission (88.7%), and contact with a TB patient was only recognized by 22 patients (11.8%). HIV serology was performed in 148 patients (79.6%); seven were positive (4.7%). About 69.3% met the criteria for malnutrition (body mass index (BMI) <18.5). Most patients, 173 (93%), presented with pulmonary TB and were new cases (94.1%). Patients were diagnosed by clinical parameters in 75% of cases. Smear microscopy was performed in 148 patients, of which 46 (31.1%) were positive, and Xpert MTB-RIF results were only obtained in 16 patients, of which 6 (37.5%) were positive. Chest x-rays were performed in most patients (71%) and were suggestive of TB in 111 (84.1%). The average length of hospital stay was 32 days (confidence interval (CI) 13-50.5). Women tend to be younger than men, have more extrapulmonary TB, and were admitted longer. Nineteen patients died during admission (10.2%). Patients who die were more frequently malnourished (92.9% of those who die were malnourished compared to 67.1% of those who did not die, p = 0.036), tend to be admitted for a shorter time than the survivors and receive more concomitant antibiotic treatment. ConclusionsIn this rural Ethiopian setting, patients admitted to the hospital for TB are often malnourished (67.1%), the main presentation is pulmonary, mortality is one in 10 admissions and very often receive antibiotics in association with TB treatment (40%).

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“…The grade of the smear is determined by the bacillary load in each microscopic field. Some studies have found that the grade of primary smear can be considered as a predictive factor of patient's morbidity and mortality, which, in the case of a higher grade of positivity, it is more likely to be a failure in treatment and cause death [7,18]. In some studies, the relationship between the grade of primary positive smear and increased clinical manifestations has been stated [19].…”

Section: Introductionmentioning

confidence: 99%

“…Chest X-ray is also a suitable and sensitive diagnostic tool for detecting pulmonary lesions, including in tuberculosis, so that in the case of a normal chest X-ray, the diagnosis of tuberculosis is partially excluded [8,12]. On the other hand, in cases where this disease is actively sought, and when it is diagnosed at an early stage, pulmonary involvement can be a sign of our success in the early detection of these patients, resulting from radiographic findings [7]. Based on the researcher's best knowledge there is no study has been conducted to investigate the relationship between the findings of chest X-ray radiography and the grade of positivity of sputum smear in Iran and especially Southeast of Iran as an area with a high prevalence of tuberculosis.…”

Section: Introductionmentioning

confidence: 99%

Sputum smear positivity grade and chest X-ray findings in tuberculosis: a cross-sectional study

Behzadmehr¹,

Nejadkehkha²

2022

Russian Journal of Infection and Immunity

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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.

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Diagnostic implications and inpatient mortality related to tuberculosis at Jimma Medical Center, southwest Ethiopia

Cited by 3 publications

References 19 publications

The Burden of Bacteriologically Negative TB Diagnosis: A Four-Year Review of Tuberculosis Cases at a Tertiary Facility

The Burden of Bacteriologically Negative TB Diagnosis: A Four-Year Review of Tuberculosis Cases at a Tertiary Facility

Diagnosis and Management of Adult Tuberculosis Patients Admitted to a Rural Hospital in Ethiopia

Sputum smear positivity grade and chest X-ray findings in tuberculosis: a cross-sectional study

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