tailieunhanh - Sputum smear negative pulmonary tuberculosis: sensitivity and specificity of diagnostic algorithm

The diagnosis of pulmonary tuberculosis in patients with Human Immunodeficiency Virus (HIV) is complicated by the increased presence of sputum smear negative tuberculosis. Diagnosis of smear negative pulmonary tuberculosis is made by an algorithm recommended by the National Tuberculosis and Leprosy Programme that uses symptoms, signs and laboratory results. The objective of this study is to determine the sensitivity and specificity of the tuberculosis treatment algorithm used for the diagnosis of sputum smear negative pulmonary tuberculosis. Methods: A cross-section study with prospective enrollment of patients was conducted in Dar-es-Salaam Tanzania. For patients with sputum smear negative, sputum was sent for culture. All consenting recruited patients were counseled and. | Swai et al. BMC Research Notes 2011 4 475 http 1756-0500 4 475 BMC Research Notes RESEARCH ARTICLE Open Access Sputum smear negative pulmonary tuberculosis sensitivity and specificity of diagnostic algorithm Hedwiga F Swai1 Ferdinand M Mugusi2 and Jessie K Mbwambo3 Abstract Background The diagnosis of pulmonary tuberculosis in patients with Human Immunodeficiency Virus HIV is complicated by the increased presence of sputum smear negative tuberculosis. Diagnosis of smear negative pulmonary tuberculosis is made by an algorithm recommended by the National Tuberculosis and Leprosy Programme that uses symptoms signs and laboratory results. The objective of this study is to determine the sensitivity and specificity of the tuberculosis treatment algorithm used for the diagnosis of sputum smear negative pulmonary tuberculosis. Methods A cross-section study with prospective enrollment of patients was conducted in Dar-es-Salaam Tanzania. For patients with sputum smear negative sputum was sent for culture. All consenting recruited patients were counseled and tested for HIV. Patients were evaluated using the National Tuberculosis and Leprosy Programme guidelines and those fulfilling the criteria of having active pulmonary tuberculosis were started on anti tuberculosis therapy. Remaining patients were provided appropriate therapy. A chest X-ray mantoux test and Full Blood Picture were done for each patient. The sensitivity and specificity of the recommended algorithm was calculated. Predictors of sputum culture positive were determined using multivariate analysis. Results During the study 467 subjects were enrolled. Of those 318 were HIV positive 127 had sputum culture positive for Mycobacteria Tuberculosis of whom 66 were correctly treated with anti-Tuberculosis drugs and 61 were missed and did not get anti-Tuberculosis drugs. Of the 286 subjects with sputum culture negative 107 were incorrectly treated with anti-Tuberculosis .