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Sputum, sex and scanty smears: new case definition may reduce sex disparities in smear-positive tuberculosis

Ramsay, Andrew, Bonnet, M., Gagnidze, L., Githui, W., Varaine, F. and Guerin, P. J. (2009) 'Sputum, sex and scanty smears: new case definition may reduce sex disparities in smear-positive tuberculosis'. International Journal of Tuberculosis and Lung Disease, Vol 13, Issue 5, pp. 613-619.

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SETTING: Urban clinic, Nairobi. OBJECTIVES: To evaluate the impact of specimen quality and different smear-positive tuberculosis (TB) case (SPC) definitions on SPC detection by sex. DESIGN: Prospective study among TB suspects. RESULTS: A total of 695 patients were recruited: 644 produced >= 1 specimen for microscopy. The male/female sex ratio was 0.8. There were no significant differences in numbers of men and women submitting three specimens (274/314 vs. 339/380, P = 0.43). Significantly more men than women produced a set of three 'good' quality specimens (175/274 vs. 182/339, P = 0.01). Lowering thresholds for definitions to include scanty smears resulted in increases in SPC detection in both sexes; the increase was significantly higher for women. The revised World Health Organization (WHO) case definition was associated with the highest detection rates in women. When analysis was restricted only to patients submitting 'good' quality specimen sets, the difference in detection between sexes was on the threshold for significance (P = 0.05). CONCLUSIONS: Higher SPC notification rates in men are commonly reported by TB control programmes. The revised WHO SPC definition may reduce sex disparities in notification. This should be considered when evaluating other interventions aimed at reducing these. Further study is required on the effects of the human immunodeficiency virus and instructed specimen collection on sex-specific impact of new SPC definition.

Item Type: Article
Uncontrolled Keywords: tuberculosis microscopy sputum diagnosis sex gender HIV
Subjects: WB Practice of Medicine > Diagnosis > General Diagnosis > WB 200 Physical diagnosis (General)
WF Respiratory System > Tuberculosis > WF 200 Tuberculosis (General)
QY Clinical Pathology > Diagnostic Tests > QY 120 Sputum
WC Communicable Diseases > Virus Diseases > Acquired Immunodeficiency Syndrome. HIV Infections > WC 503 Acquired immunodeficiency syndrome. HIV infections
WF Respiratory System > Tuberculosis > WF 220 Diagnosis. Prognosis
QY Clinical Pathology > Diagnostic Tests > QY 250 Immunodiagnostic tests
QY Clinical Pathology > QY 4 General works
Faculty: Department: Groups (2002 - 2012) > Clinical Group
Depositing User: Users 43 not found.
Date Deposited: 13 Jul 2010 14:08
Last Modified: 06 Feb 2018 12:59


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