Sputum smear-positive tuberculosis: empiric evidence challenges the need for confirmatory smears
OBJECTIVE: To determine the frequency of single scanty or positive sputum smear results and its impact on the surveillance definition of sputum smear-positive tuberculosis (TB).SETTING: Moldova, Mongolia, Uganda and Zimbabwe.METHODS: A representative sample of laboratories was selected in each count...
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| Veröffentlicht in: | The international journal of tuberculosis and lung disease 2007-09, Vol.11 (9), p.959-964 |
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| container_title | The international journal of tuberculosis and lung disease |
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| creator | MABAERA, B LAURITSEN, J. M KATAMBA, A LATICEVSCHI, D NARANBAT, N RIEDER, H. L |
| description | OBJECTIVE: To determine the frequency of single scanty or positive sputum smear results and its impact on the surveillance definition of sputum smear-positive tuberculosis (TB).SETTING: Moldova, Mongolia, Uganda and Zimbabwe.METHODS: A representative sample of laboratories was
selected in each country. Data were double-entered and discordances resolved by rechecking the register.RESULTS: The dataset comprised 128808 examinees with valid information from 23 laboratories in Moldova, all 31 in Mongolia, 30 in Uganda and 23 in Zimbabwe, each covering at least one
calendar year. The reason for the examination was diagnostic for 89362, of which 15.2% (n = 13577) were defined as laboratory cases with at least one bacillus on at least one examination. Cases were confirmed by another examination in 72.6% (n = 9861). Of the 9014
cases who had a full set of three examinations, confirmation was obtained in 92.4% (n = 8325).CONCLUSION: One quarter of laboratory cases had no confirmatory result, almost entirely attributable to not examining another specimen. The current definition of sputum smear-positive
TB requires two positive smears or one positive smear result plus more complex confirmatory evidence. Accepting a single positive examination as sufficient for the definition would greatly increase the sensitivity of the surveillance definition without sacrificing its specificity. |
| format | Article |
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selected in each country. Data were double-entered and discordances resolved by rechecking the register.RESULTS: The dataset comprised 128808 examinees with valid information from 23 laboratories in Moldova, all 31 in Mongolia, 30 in Uganda and 23 in Zimbabwe, each covering at least one
calendar year. The reason for the examination was diagnostic for 89362, of which 15.2% (n = 13577) were defined as laboratory cases with at least one bacillus on at least one examination. Cases were confirmed by another examination in 72.6% (n = 9861). Of the 9014
cases who had a full set of three examinations, confirmation was obtained in 92.4% (n = 8325).CONCLUSION: One quarter of laboratory cases had no confirmatory result, almost entirely attributable to not examining another specimen. The current definition of sputum smear-positive
TB requires two positive smears or one positive smear result plus more complex confirmatory evidence. Accepting a single positive examination as sufficient for the definition would greatly increase the sensitivity of the surveillance definition without sacrificing its specificity.</description><identifier>ISSN: 1027-3719</identifier><identifier>EISSN: 1815-7920</identifier><identifier>PMID: 17705972</identifier><language>eng</language><publisher>Paris, France: IUATLD</publisher><subject>Bacillus ; Bacterial diseases ; Bacteriological Techniques - methods ; Biological and medical sciences ; Case Definition ; Databases as Topic ; Diagnosis ; Human bacterial diseases ; Humans ; Infectious diseases ; Laboratories ; Medical sciences ; Microscopy ; Miscellaneous ; Moldova ; Mongolia ; Mycobacterium - isolation & purification ; Pneumology ; Population Surveillance - methods ; Predictive Value of Tests ; Prevention and actions ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; Specimen Handling ; Sputum - microbiology ; Surveillance ; Tuberculosis ; Tuberculosis - diagnosis ; Tuberculosis - microbiology ; Tuberculosis and atypical mycobacterial infections ; Uganda ; Zimbabwe</subject><ispartof>The international journal of tuberculosis and lung disease, 2007-09, Vol.11 (9), p.959-964</ispartof><rights>2007 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=19021492$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17705972$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>MABAERA, B</creatorcontrib><creatorcontrib>LAURITSEN, J. M</creatorcontrib><creatorcontrib>KATAMBA, A</creatorcontrib><creatorcontrib>LATICEVSCHI, D</creatorcontrib><creatorcontrib>NARANBAT, N</creatorcontrib><creatorcontrib>RIEDER, H. L</creatorcontrib><title>Sputum smear-positive tuberculosis: empiric evidence challenges the need for confirmatory smears</title><title>The international journal of tuberculosis and lung disease</title><addtitle>Int J Tuberc Lung Dis</addtitle><description>OBJECTIVE: To determine the frequency of single scanty or positive sputum smear results and its impact on the surveillance definition of sputum smear-positive tuberculosis (TB).SETTING: Moldova, Mongolia, Uganda and Zimbabwe.METHODS: A representative sample of laboratories was
selected in each country. Data were double-entered and discordances resolved by rechecking the register.RESULTS: The dataset comprised 128808 examinees with valid information from 23 laboratories in Moldova, all 31 in Mongolia, 30 in Uganda and 23 in Zimbabwe, each covering at least one
calendar year. The reason for the examination was diagnostic for 89362, of which 15.2% (n = 13577) were defined as laboratory cases with at least one bacillus on at least one examination. Cases were confirmed by another examination in 72.6% (n = 9861). Of the 9014
cases who had a full set of three examinations, confirmation was obtained in 92.4% (n = 8325).CONCLUSION: One quarter of laboratory cases had no confirmatory result, almost entirely attributable to not examining another specimen. The current definition of sputum smear-positive
TB requires two positive smears or one positive smear result plus more complex confirmatory evidence. Accepting a single positive examination as sufficient for the definition would greatly increase the sensitivity of the surveillance definition without sacrificing its specificity.</description><subject>Bacillus</subject><subject>Bacterial diseases</subject><subject>Bacteriological Techniques - methods</subject><subject>Biological and medical sciences</subject><subject>Case Definition</subject><subject>Databases as Topic</subject><subject>Diagnosis</subject><subject>Human bacterial diseases</subject><subject>Humans</subject><subject>Infectious diseases</subject><subject>Laboratories</subject><subject>Medical sciences</subject><subject>Microscopy</subject><subject>Miscellaneous</subject><subject>Moldova</subject><subject>Mongolia</subject><subject>Mycobacterium - isolation & purification</subject><subject>Pneumology</subject><subject>Population Surveillance - methods</subject><subject>Predictive Value of Tests</subject><subject>Prevention and actions</subject><subject>Public health. Hygiene</subject><subject>Public health. Hygiene-occupational medicine</subject><subject>Specimen Handling</subject><subject>Sputum - microbiology</subject><subject>Surveillance</subject><subject>Tuberculosis</subject><subject>Tuberculosis - diagnosis</subject><subject>Tuberculosis - microbiology</subject><subject>Tuberculosis and atypical mycobacterial infections</subject><subject>Uganda</subject><subject>Zimbabwe</subject><issn>1027-3719</issn><issn>1815-7920</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkU2L1TAUhosozof-BclGd4UkTZrEnYzOBwwoqOuYpqczuaRpzceF8ddPOvcOrsQsknPg4eXkOS-aUyIJb4Wi-GWtMRVtJ4g6ac5S2mFMCSHidXNChMBcCXra_Pq-llxmlGYwsV2X5LLbA8plgGiLr336iGBeXXQWwd6NECwge2-8h3AHCeV7QAFgRNMSkV3C5OJs8hIfDpHpTfNqMj7B2-N73vy8_PLj4rq9_Xp1c_HptnUMs9x2gyW0zjuAsaOUdhKjHWwnyTDyXklLSM8Zq20n-8kMAxZc2Z5b4IwwifvuvPlwyF3j8rtAynp2yYL3JsBSku4lEYz1_L8gxR2WmMoKvjuCZZhh1Gt0s4kP-lleBd4fAZOs8VM0wbr0l1PVN1Mb9_nAuWosZKN3S4mhytCumOxH7XbbTTEWGj8dQo4FVtrEvBXbD7_9K8Y-J20b3xau94QEVSOrU0m5JtWdHmEyxWedTdR3f3Tqu0fsT6sa</recordid><startdate>20070901</startdate><enddate>20070901</enddate><creator>MABAERA, B</creator><creator>LAURITSEN, J. M</creator><creator>KATAMBA, A</creator><creator>LATICEVSCHI, D</creator><creator>NARANBAT, N</creator><creator>RIEDER, H. L</creator><general>IUATLD</general><general>Union internationale contre la tuberculose et les maladies respiratoires</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7QL</scope><scope>C1K</scope><scope>7X8</scope></search><sort><creationdate>20070901</creationdate><title>Sputum smear-positive tuberculosis: empiric evidence challenges the need for confirmatory smears</title><author>MABAERA, B ; LAURITSEN, J. M ; KATAMBA, A ; LATICEVSCHI, D ; NARANBAT, N ; RIEDER, H. L</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-i404t-3bc12102beacd88cf7dcbc381bd5698c11654481b386fabb0759c65ce54148063</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Bacillus</topic><topic>Bacterial diseases</topic><topic>Bacteriological Techniques - methods</topic><topic>Biological and medical sciences</topic><topic>Case Definition</topic><topic>Databases as Topic</topic><topic>Diagnosis</topic><topic>Human bacterial diseases</topic><topic>Humans</topic><topic>Infectious diseases</topic><topic>Laboratories</topic><topic>Medical sciences</topic><topic>Microscopy</topic><topic>Miscellaneous</topic><topic>Moldova</topic><topic>Mongolia</topic><topic>Mycobacterium - isolation & purification</topic><topic>Pneumology</topic><topic>Population Surveillance - methods</topic><topic>Predictive Value of Tests</topic><topic>Prevention and actions</topic><topic>Public health. Hygiene</topic><topic>Public health. Hygiene-occupational medicine</topic><topic>Specimen Handling</topic><topic>Sputum - microbiology</topic><topic>Surveillance</topic><topic>Tuberculosis</topic><topic>Tuberculosis - diagnosis</topic><topic>Tuberculosis - microbiology</topic><topic>Tuberculosis and atypical mycobacterial infections</topic><topic>Uganda</topic><topic>Zimbabwe</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>MABAERA, B</creatorcontrib><creatorcontrib>LAURITSEN, J. M</creatorcontrib><creatorcontrib>KATAMBA, A</creatorcontrib><creatorcontrib>LATICEVSCHI, D</creatorcontrib><creatorcontrib>NARANBAT, N</creatorcontrib><creatorcontrib>RIEDER, H. L</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Environmental Sciences and Pollution Management</collection><collection>MEDLINE - Academic</collection><jtitle>The international journal of tuberculosis and lung disease</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>MABAERA, B</au><au>LAURITSEN, J. M</au><au>KATAMBA, A</au><au>LATICEVSCHI, D</au><au>NARANBAT, N</au><au>RIEDER, H. L</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Sputum smear-positive tuberculosis: empiric evidence challenges the need for confirmatory smears</atitle><jtitle>The international journal of tuberculosis and lung disease</jtitle><addtitle>Int J Tuberc Lung Dis</addtitle><date>2007-09-01</date><risdate>2007</risdate><volume>11</volume><issue>9</issue><spage>959</spage><epage>964</epage><pages>959-964</pages><issn>1027-3719</issn><eissn>1815-7920</eissn><abstract>OBJECTIVE: To determine the frequency of single scanty or positive sputum smear results and its impact on the surveillance definition of sputum smear-positive tuberculosis (TB).SETTING: Moldova, Mongolia, Uganda and Zimbabwe.METHODS: A representative sample of laboratories was
selected in each country. Data were double-entered and discordances resolved by rechecking the register.RESULTS: The dataset comprised 128808 examinees with valid information from 23 laboratories in Moldova, all 31 in Mongolia, 30 in Uganda and 23 in Zimbabwe, each covering at least one
calendar year. The reason for the examination was diagnostic for 89362, of which 15.2% (n = 13577) were defined as laboratory cases with at least one bacillus on at least one examination. Cases were confirmed by another examination in 72.6% (n = 9861). Of the 9014
cases who had a full set of three examinations, confirmation was obtained in 92.4% (n = 8325).CONCLUSION: One quarter of laboratory cases had no confirmatory result, almost entirely attributable to not examining another specimen. The current definition of sputum smear-positive
TB requires two positive smears or one positive smear result plus more complex confirmatory evidence. Accepting a single positive examination as sufficient for the definition would greatly increase the sensitivity of the surveillance definition without sacrificing its specificity.</abstract><cop>Paris, France</cop><pub>IUATLD</pub><pmid>17705972</pmid><tpages>6</tpages></addata></record> |
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| subjects | Bacillus Bacterial diseases Bacteriological Techniques - methods Biological and medical sciences Case Definition Databases as Topic Diagnosis Human bacterial diseases Humans Infectious diseases Laboratories Medical sciences Microscopy Miscellaneous Moldova Mongolia Mycobacterium - isolation & purification Pneumology Population Surveillance - methods Predictive Value of Tests Prevention and actions Public health. Hygiene Public health. Hygiene-occupational medicine Specimen Handling Sputum - microbiology Surveillance Tuberculosis Tuberculosis - diagnosis Tuberculosis - microbiology Tuberculosis and atypical mycobacterial infections Uganda Zimbabwe |
| title | Sputum smear-positive tuberculosis: empiric evidence challenges the need for confirmatory smears |
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