Use of Mycobacterial Smears in the Diagnosis of Pulmonary Tuberculosis in AIDS/ARC Patients

Klein, Natalie C.; Duncanson, Frederick P.; Lenox, Theodore; Pitta, Africa; Cohen, Steven C.; Wormser, Gary P.

doi:10.1378/chest.95.6.1190

Cited by 122 publications

(43 citation statements)

References 5 publications

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“…Although Klein et al (1989) has reported a smear-positivity rate of sputum specimens from HIV positive patients lower than the rate from individuals not infected with HIV, Yajko et al (1994) and Theuer et al (1990) found no difference beetwen smear-positivity rate of sputum specimens of these two groups of patients. In our study, the smear positivity rate of sputum and BAL specimens from HIV positive patients tend to be lower than that observed among specimens from patients HIV negative and those with no HIV test performed.…”

Section: Discussionmentioning

confidence: 81%

Predictive value of the acid fast smear for detection of Mycobacterium tuberculosis in respiratory specimens in a Reference Center of HIV/Aids in Rio de Janeiro, Brazil

Conde

Figueira

Moraes

et al. 1999

Mem. Inst. Oswaldo Cruz

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Section: Discussionmentioning

confidence: 81%

Predictive value of the acid fast smear for detection of Mycobacterium tuberculosis in respiratory specimens in a Reference Center of HIV/Aids in Rio de Janeiro, Brazil

Conde

Figueira

Moraes

et al. 1999

Mem. Inst. Oswaldo Cruz

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“…Other studies have also shown traditional diagnostic methods to have low yields. One group of authors, (11) working in the United States, found positive sputum smear microscopy results in only 29% of patients with HIV/AIDS, compared with 61% of HIV-negative patients, whereas others, (12) working in Malaysia, found positive sputum smear microscopy results in 51% of TB/HIV co-infected individuals with respiratory symptoms.…”

Section: Discussionmentioning

confidence: 99%

Desfecho do tratamento e confirmação laboratorial do diagnóstico de tuberculose em pacientes com HIV/AIDS no Recife, Pernambuco, Brasil

2008

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OBJETIVO: Comparar a freqüência de desfecho desfavorável (óbito, abandono e falência de tratamento) entre pacientes com co-infecção tuberculose (TB)/HIV submetidos a tratamento para TB com confirmação etiológica do diagnóstico e pacientes co-infectados com TB/HIV e tratados sem confirmação diagnóstica. MÉTODOS: Coorte retrospectivo de pacientes co-infectados com TB/HIV que iniciaram tratamento para TB entre julho de 2002 e junho de 2004, em um serviço de referência para HIV/AIDS no Recife (PE) Brasil. A exposição principal, confirmação laboratorial da TB, foi ajustada pelas variáveis de três blocos: variáveis sócio-demográficas; variáveis relacionadas ao HIV/AIDS; e variáveis relacionadas à TB. Para avaliar a significância estatística dos resultados, utilizaram-se o intervalo de confiança de 95% das odds ratios e o valor de p (teste de qui-quadrado e razão de verossimilhança). RESULTADOS: Foram estudados 262 pacientes. Não se observou associação entre confirmação laboratorial do diagnóstico de TB e desfecho desfavorável, mesmo após o ajuste pelos fatores de confusão. Permaneceram no modelo final da regressão logística múltipla: coexistência de outras doenças oportunistas; contagem de linfócitos CD4 abaixo de 50 células/mm³; carga viral entre 10.000 e 100.000 cópias/mL; dispnéia; forma disseminada de TB; e mudança do tratamento da TB por reação adversa ou intolerância. CONCLUSÕES: Os resultados sugerem que o tratamento para TB sem confirmação etiológica, em pacientes co-infectados, baseado na decisão de profissionais experientes em serviços de referência, não aumentou o risco de desfecho desfavorável do tratamento para TB. Além disso, identificaram-se grupos com maior risco de desfecho desfavorável, os quais devem ser cuidadosamente monitorados.

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“…The large proportion of smear negative pulmonary TB cases might be due to high proportion of TB-HIV co-infection at the study area, as shown by a previous study [15]. HIV-infected patients are twice as likely to have sputum smear-negative, culture-positive pulmonary TB [23][24][25].This may result from their compromised immune response cause less cavity development [26].…”

Section: Discussionmentioning

confidence: 74%

Treatment Outcome of Tuberculosis Patients under Directly Observed Treatment of Short Course in Benishangul Gumuz Region, Western Ethiopia: A Ten-Year Retrospective Study

Disassa¹,

Teklu²,

Tafess³

et al. 2015

Gen Med (Los Angel)

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A retrospective study was conducted to assess TB treatment outcome and thus evaluate DOTS programme in Benishangul Gumuz Region, western Ethiopia. The records of 3658 TB patients registered in the two hospitals between November, 2003 and October, 2012 at DOTS Clinics were analyzed. From the total patients, 2,223 (60.77%) were successfully treated, 315 (8.61%) lost to follow up, 341 (9.32%) died, 4 (0.11%) failed treatment and 775 (21.19%) not evaluated. There is no association in treatment success rate between new and previously treated patients (60.55% vs. 58.33%, X 2 =0.14; P>0.704). When transferred out (not evaluated) is excluded, the success rate was increased approximately by a rate of 0.03 times while the time is increased by one year (β=0.03106; CI=0.0218-0.0403). Smear negative pulmonary TB patients had 1.24 times low treatment success rate (64.08% vs. 58.07%; CI=1.02-1.51; P<0.001) compared to smear positive. Patients from Pawe areas had 1.34 times lower treatment success rate compared to cases from Assosa (64.91% vs. 58.57%; CI=1.16-1.55). Not evaluated and lost to follow up rates were higher in Pawe (24.93% vs. 14.16%; X 2 =38.66; P<0.001 and 10.10% vs. 5.82%; X 2 =16.40; P<0.001 respectively) while death rate was higher in Assosa (14.95% vs. 6.33%; X 2 =59.05; P<0.001). Accordingly, males and elders had the trend to be more likely to experience death. In conclusion, the treatment success rate of TB patients was low which accounts for 60.77%. Low treatment success and high proportion of death (9.32%) and defaulted (8.61%) rates are serious public health concerns that point out low DOTs programme performance in the study areas.

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Use of Mycobacterial Smears in the Diagnosis of Pulmonary Tuberculosis in AIDS/ARC Patients

Cited by 122 publications

References 5 publications

Predictive value of the acid fast smear for detection of Mycobacterium tuberculosis in respiratory specimens in a Reference Center of HIV/Aids in Rio de Janeiro, Brazil

Predictive value of the acid fast smear for detection of Mycobacterium tuberculosis in respiratory specimens in a Reference Center of HIV/Aids in Rio de Janeiro, Brazil

Desfecho do tratamento e confirmação laboratorial do diagnóstico de tuberculose em pacientes com HIV/AIDS no Recife, Pernambuco, Brasil

Treatment Outcome of Tuberculosis Patients under Directly Observed Treatment of Short Course in Benishangul Gumuz Region, Western Ethiopia: A Ten-Year Retrospective Study

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