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Short-term bleach digestion of sputum in the diagnosis of pulmonary tuberculosis in patients co-infected with HIV

Lawson, Lovett, Yassin, Mohammed A., Ramsay, Andrew, Emenyonu, E. N., Thacher, T. D., Davies, P. D. O., Squire, Bertie ORCID: https://orcid.org/0000-0001-7173-9038 and Cuevas, Luis ORCID: https://orcid.org/0000-0002-6581-0587 (2007) 'Short-term bleach digestion of sputum in the diagnosis of pulmonary tuberculosis in patients co-infected with HIV'. Tuberculosis, Vol 87, Issue 4, pp. 368-372.

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Abstract

The bleach digestion of sputum may improve the yield of smear microscopy but has not been validated in patients with HIV. Therefore we assessed the performance of bleach-digested smear microscopy among patients with HIV. One thousand three hundred and twenty one patients with chronic cough submitted three sputum samples for direct smear microscopy and were offered HIV tests. One sample was selected for a bleach-digested smear and another one was cultured. Patients were classified as having 'definite' (>= 2 positive smears), 'very likely' (smear-negative, culture- positive), 'less likely' (one smear-positive, culture-negative) and 'unlikely' (smear and culture negative) tuberculosis (TB). In all, 566/1045 (54%) patients were HIV positive and 731/1186 (62%) were culture positive. The digested smears were positive in 123/125 (98%) 'definite', 4/118 (3%) 'very likely' and 1/174 'unlikely' TB patients with HIV and in 125/127 (98%) 'definite', 2/74 (3%) 'very likely', 4/4 'less likely' and 2/127 'unlikely' TB without HIV. Three direct smears identified 252 (57%) and one digested smear 254 (57%) of the 444 patients with 'definite' or 'very likely' TB. One bleach-digested smear performed similarly to three direct smears. Both methods were less sensitive in HIV-positive patients. Further studies are needed to compare the performance of the two methods under operational conditions. (c) 2007 Elsevier Ltd. All rights reserved.

Item Type: Article
Uncontrolled Keywords: tuberculosis diagnosis bleach digestion hiv nigeria developing-countries smear microscopy sensitivity ethiopia
Subjects: WC Communicable Diseases > Virus Diseases > Acquired Immunodeficiency Syndrome. HIV Infections > WC 503.5 Complications
WF Respiratory System > Tuberculosis > WF 220 Diagnosis. Prognosis
Faculty: Department: Groups (2002 - 2012) > Child & Reproductive Health Group
Groups (2002 - 2012) > Clinical Group
Digital Object Identifer (DOI): https://doi.org/10.1016/j.tube.2007.02.002
Depositing User: Ms Julia Martin
Date Deposited: 18 Oct 2010 11:00
Last Modified: 09 Aug 2017 01:02
URI: https://archive.lstmed.ac.uk/id/eprint/1229

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