Should sputum smear examination be carried out at the end of the intensive phase and end of treatment in sputum smear negative pulmonary TB patients?

<h4>Background</h4>The Indian guidelines on following up sputum smear-negative Pulmonary tuberculosis (PTB) patients differ from the current World Health Organization (WHO) guidelines in that the former recommends two follow up sputum examinations (once at the end of intensive phase and...

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Autores principales:	Sumit Malhotra, Sanjay P Zodpey, Shivani Chandra, Ram Pal Vashist, Srinath Satyanaryana, Rony Zachariah, Anthony D Harries
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2012
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/ac30aaf7d6b44ec7b81fb4c788eb08ae
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spelling	oai:doaj.org-article:ac30aaf7d6b44ec7b81fb4c788eb08ae2021-11-18T08:09:12ZShould sputum smear examination be carried out at the end of the intensive phase and end of treatment in sputum smear negative pulmonary TB patients?1932-620310.1371/journal.pone.0049238https://doaj.org/article/ac30aaf7d6b44ec7b81fb4c788eb08ae2012-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23152880/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>The Indian guidelines on following up sputum smear-negative Pulmonary tuberculosis (PTB) patients differ from the current World Health Organization (WHO) guidelines in that the former recommends two follow up sputum examinations (once at the end of intensive phase and the other at the end of treatment) while the latter recommends only one follow up sputum smear microscopy examination, which is done at the end of the intensive phase. This study was conducted to examine if there was any added value in performing an additional sputum smear examination at the end of treatment within the context of a national TB program.<h4>Methods</h4>This study was a descriptive record based review conducted in nine tuberculosis (TB) units in Delhi, India. All consecutive new sputum smear-negative PTB patients registered in these nine TB units from 1(st) January 2009 to 31(st) December 2009 were included in the study.<h4>Results</h4>Of 2567 new sputum smear-negative TB patients, 1973 (90%) had sputum specimens examined at the end of the intensive phase, of whom 36 (2%) were smear-positive: the majority (n = 28) successfully completed treatment with either the same or a re-treatment regimen. At treatment completion, 1766 (85%) patients had sputum specimens examined, of whom 16 (0.9%) were smear-positive: all these were changed to a re-treatment regimen. Amongst the sputum-positive patients identified as a result of follow up (n = 52), four were diagnosed with multi-drug resistant TB (MDR-TB), three of whom were detected after smear examination at the end of treatment.<h4>Conclusions</h4>Given the high burden of TB in India, a 0.9% additional yield of smear-positive sputum smears at the end of treatment translates to 3,297 cases of smear-positive PTB. End-of-treatment smear is a low-yield strategy for detection of smear-positive TB cases, although further studies are needed to determine its population-level impact and cost, particularly in relation to other TB control interventions.Sumit MalhotraSanjay P ZodpeyShivani ChandraRam Pal VashistSrinath SatyanaryanaRony ZachariahAnthony D HarriesPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 7, Iss 11, p e49238 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Sumit Malhotra Sanjay P Zodpey Shivani Chandra Ram Pal Vashist Srinath Satyanaryana Rony Zachariah Anthony D Harries Should sputum smear examination be carried out at the end of the intensive phase and end of treatment in sputum smear negative pulmonary TB patients?
description	<h4>Background</h4>The Indian guidelines on following up sputum smear-negative Pulmonary tuberculosis (PTB) patients differ from the current World Health Organization (WHO) guidelines in that the former recommends two follow up sputum examinations (once at the end of intensive phase and the other at the end of treatment) while the latter recommends only one follow up sputum smear microscopy examination, which is done at the end of the intensive phase. This study was conducted to examine if there was any added value in performing an additional sputum smear examination at the end of treatment within the context of a national TB program.<h4>Methods</h4>This study was a descriptive record based review conducted in nine tuberculosis (TB) units in Delhi, India. All consecutive new sputum smear-negative PTB patients registered in these nine TB units from 1(st) January 2009 to 31(st) December 2009 were included in the study.<h4>Results</h4>Of 2567 new sputum smear-negative TB patients, 1973 (90%) had sputum specimens examined at the end of the intensive phase, of whom 36 (2%) were smear-positive: the majority (n = 28) successfully completed treatment with either the same or a re-treatment regimen. At treatment completion, 1766 (85%) patients had sputum specimens examined, of whom 16 (0.9%) were smear-positive: all these were changed to a re-treatment regimen. Amongst the sputum-positive patients identified as a result of follow up (n = 52), four were diagnosed with multi-drug resistant TB (MDR-TB), three of whom were detected after smear examination at the end of treatment.<h4>Conclusions</h4>Given the high burden of TB in India, a 0.9% additional yield of smear-positive sputum smears at the end of treatment translates to 3,297 cases of smear-positive PTB. End-of-treatment smear is a low-yield strategy for detection of smear-positive TB cases, although further studies are needed to determine its population-level impact and cost, particularly in relation to other TB control interventions.
format	article
author	Sumit Malhotra Sanjay P Zodpey Shivani Chandra Ram Pal Vashist Srinath Satyanaryana Rony Zachariah Anthony D Harries
author_facet	Sumit Malhotra Sanjay P Zodpey Shivani Chandra Ram Pal Vashist Srinath Satyanaryana Rony Zachariah Anthony D Harries
author_sort	Sumit Malhotra
title	Should sputum smear examination be carried out at the end of the intensive phase and end of treatment in sputum smear negative pulmonary TB patients?
title_short	Should sputum smear examination be carried out at the end of the intensive phase and end of treatment in sputum smear negative pulmonary TB patients?
title_full	Should sputum smear examination be carried out at the end of the intensive phase and end of treatment in sputum smear negative pulmonary TB patients?
title_fullStr	Should sputum smear examination be carried out at the end of the intensive phase and end of treatment in sputum smear negative pulmonary TB patients?
title_full_unstemmed	Should sputum smear examination be carried out at the end of the intensive phase and end of treatment in sputum smear negative pulmonary TB patients?
title_sort	should sputum smear examination be carried out at the end of the intensive phase and end of treatment in sputum smear negative pulmonary tb patients?
publisher	Public Library of Science (PLoS)
publishDate	2012
url	https://doaj.org/article/ac30aaf7d6b44ec7b81fb4c788eb08ae
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Should sputum smear examination be carried out at the end of the intensive phase and end of treatment in sputum smear negative pulmonary TB patients?

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