Performance of the new WHO diagnostic algorithm for smear-negative pulmonary tuberculosis in HIV prevalent settings: a multisite study in Uganda

Tropical Medicine & International Health : TM & IH
Stella-Talisuna AlamoElly Katabira

Abstract

To compare the performance of the new WHO (2007) diagnostic algorithm for pulmonary tuberculosis (PTB) in high HIV prevalent settings (WHO07) to the WHO 2003 guidelines used by the Ugandan National Tuberculosis Program (UgWHO03). A prospective observational cohort design was used at Reach Out Mbuya Parish HIV/AIDS Initiative, an urban slum community-based AIDS Service Organisation (ASO) and Kayunga Rural District Government Hospital. Newly diagnosed and enrolled HIV-infected patients were assessed for PTB. Research staff interviewed patients and staff and observed operational constraints. WHO07 reduced the time to diagnosis of smear-negative PTB with increased sensitivity compared with the UgWHO03 at both sites. Time to diagnosis of smear-negative PTB was significantly shorter at the urban ASO than at the rural ASO (12.4 vs. 28.5 days, P = 0.003). Diagnostic specificity and sensitivity [95% confidence intervals (CIs)] for smear-negative PTB were higher at the rural hospital compared with the urban ASO: [98% (93-100%) vs. 86% (77-92%), P = 0.001] and [95% (72-100%) vs. 90% (54-99%), P > 0.05], respectively. Common barriers to implementation of algorithms included failure by patients to attend follow-up appointments and poor adhe...Continue Reading

References

Nov 1, 1995·American Journal of Respiratory and Critical Care Medicine·C AndersonD Menzies
Feb 1, 1995·Tubercle and Lung Disease : the Official Journal of the International Union Against Tuberculosis and Lung Disease·C M ParryC A Hart
Oct 1, 1993·Tropical Doctor·C M Parry
Jul 1, 1997·Transactions of the Royal Society of Tropical Medicine and Hygiene·D WilkinsonA W Sturm
May 3, 2003·The Lancet Infectious Diseases·Kamran SiddiqiJohn Walley
Mar 24, 2006·Tropical Medicine & International Health : TM & IH·Kamran SiddiqiN Safdar
Sep 24, 2008·Seminars in Respiratory and Critical Care Medicine·Knut Lönnroth, Mario Raviglione
Feb 6, 2009·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Larry W ChangSteven J Reynolds
Jun 4, 2011·Journal of Acquired Immune Deficiency Syndromes : JAIDS·John WalleyAhmed Matovu

❮ Previous
Next ❯

Citations

May 29, 2016·International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases·João B de O Souza FilhoAfranio Lineu Kritski
Apr 17, 2018·Expert Review of Molecular Diagnostics·Natasha GousRosanna W Peeling
Jul 2, 2020·Critical Reviews in Clinical Laboratory Sciences·Vinoth Kumar RajendranAnwar Sunna

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.