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A four-year trend in pulmonary bacteriologically confirmed tuberculosis case detection in Kampala-Uganda

BACKGROUND: The management and control of pulmonary bacteriologically confirmed (PBC) tuberculosis (TB) also known as infectious TB is important not only to monitor for resistance but also to check for severity, treatment response and limit its spread. METHOD: A retrospective analysis of diagnosis s...

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Autores principales: Kirirabwa, Nicholas Sebuliba, Kimuli, Derrick, Nanziri, Carol, Sama, Denis, Ntudhu, Syrus, Okello, Daniel Ayen, Byaruhanga, Raymond, Lukoye, Deus, Kasozi, Samuel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6509788/
https://www.ncbi.nlm.nih.gov/pubmed/31077178
http://dx.doi.org/10.1186/s12890-019-0853-3
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author Kirirabwa, Nicholas Sebuliba
Kimuli, Derrick
Nanziri, Carol
Sama, Denis
Ntudhu, Syrus
Okello, Daniel Ayen
Byaruhanga, Raymond
Lukoye, Deus
Kasozi, Samuel
author_facet Kirirabwa, Nicholas Sebuliba
Kimuli, Derrick
Nanziri, Carol
Sama, Denis
Ntudhu, Syrus
Okello, Daniel Ayen
Byaruhanga, Raymond
Lukoye, Deus
Kasozi, Samuel
author_sort Kirirabwa, Nicholas Sebuliba
collection PubMed
description BACKGROUND: The management and control of pulmonary bacteriologically confirmed (PBC) tuberculosis (TB) also known as infectious TB is important not only to monitor for resistance but also to check for severity, treatment response and limit its spread. METHOD: A retrospective analysis of diagnosis smear results of PBC TB patients in Kampala district registered between January 2012 and December 2015 at 65 TB diagnosis and treatment units (DTUs) was done. RESULTS: Of the 10,404 records; 6551 (63.0%) belonged to PBC TB patients, 3734 (57.0%) of whom were male. Sputum smear microscopy was the diagnostic test most commonly used 4905 (74.9%) followed by GeneXpert testing, 1023 (15.6%). Majority, 1951 (39.8%), of the PBC TB patients had a smear positivity grading of 3+ (> 10 acid-fast bacillus (AFB)/Fields). Public facilities diagnosed more PBC TB patients compared to private facilities, 3983 (60.8%) vs 2566 (39.2%). From 2012 through 2015, there was a statistically significant increase in PBC TB patients enrolled on anti-TB treatment from 1389 to 2194 (p = 0.000). The percentage of HIV positive co-infected PBC TB patients diagnosed decreased from 597(43%) to 890(40.6%) (p = 0.000) within same period. Linkage to HIV care improved from 229 (34.4%) in 2012 to 464 (52.1%) in 2015 (p = 0.000). The treatment success rate (TSR) for PBC TB patients improved from 69% in 2012 to 75.5% by end of 2015 (p = 0.001) with an improvement in cure rate from 52.3% to 62% (p = 0.000). There was an observed significant decrease in TB related mortality from 8.9 to 6.4% (p = 0.013). CONCLUSION: The proportion of diagnosed PBC TB patients increased from 2012 to 2015. PBC TB patients diagnosed with 3+ smear positivity grading results consistently contributed to the highest proportion of diagnosed PBC TB patients from 2012 to 2015. This could be due to the delay in diagnosis of TB patients because of late presentation of patients to clinics. A prospective study of PBC TB patients diagnosed with 3+ smear positivity grading may elucidate the reasons for the delay to diagnosis. Further, we propose a study of wider scope to estimate how many people a single PBC TB patient is likely to infect with TB before being diagnosed and treated.
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spelling pubmed-65097882019-06-05 A four-year trend in pulmonary bacteriologically confirmed tuberculosis case detection in Kampala-Uganda Kirirabwa, Nicholas Sebuliba Kimuli, Derrick Nanziri, Carol Sama, Denis Ntudhu, Syrus Okello, Daniel Ayen Byaruhanga, Raymond Lukoye, Deus Kasozi, Samuel BMC Pulm Med Research Article BACKGROUND: The management and control of pulmonary bacteriologically confirmed (PBC) tuberculosis (TB) also known as infectious TB is important not only to monitor for resistance but also to check for severity, treatment response and limit its spread. METHOD: A retrospective analysis of diagnosis smear results of PBC TB patients in Kampala district registered between January 2012 and December 2015 at 65 TB diagnosis and treatment units (DTUs) was done. RESULTS: Of the 10,404 records; 6551 (63.0%) belonged to PBC TB patients, 3734 (57.0%) of whom were male. Sputum smear microscopy was the diagnostic test most commonly used 4905 (74.9%) followed by GeneXpert testing, 1023 (15.6%). Majority, 1951 (39.8%), of the PBC TB patients had a smear positivity grading of 3+ (> 10 acid-fast bacillus (AFB)/Fields). Public facilities diagnosed more PBC TB patients compared to private facilities, 3983 (60.8%) vs 2566 (39.2%). From 2012 through 2015, there was a statistically significant increase in PBC TB patients enrolled on anti-TB treatment from 1389 to 2194 (p = 0.000). The percentage of HIV positive co-infected PBC TB patients diagnosed decreased from 597(43%) to 890(40.6%) (p = 0.000) within same period. Linkage to HIV care improved from 229 (34.4%) in 2012 to 464 (52.1%) in 2015 (p = 0.000). The treatment success rate (TSR) for PBC TB patients improved from 69% in 2012 to 75.5% by end of 2015 (p = 0.001) with an improvement in cure rate from 52.3% to 62% (p = 0.000). There was an observed significant decrease in TB related mortality from 8.9 to 6.4% (p = 0.013). CONCLUSION: The proportion of diagnosed PBC TB patients increased from 2012 to 2015. PBC TB patients diagnosed with 3+ smear positivity grading results consistently contributed to the highest proportion of diagnosed PBC TB patients from 2012 to 2015. This could be due to the delay in diagnosis of TB patients because of late presentation of patients to clinics. A prospective study of PBC TB patients diagnosed with 3+ smear positivity grading may elucidate the reasons for the delay to diagnosis. Further, we propose a study of wider scope to estimate how many people a single PBC TB patient is likely to infect with TB before being diagnosed and treated. BioMed Central 2019-05-10 /pmc/articles/PMC6509788/ /pubmed/31077178 http://dx.doi.org/10.1186/s12890-019-0853-3 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Kirirabwa, Nicholas Sebuliba
Kimuli, Derrick
Nanziri, Carol
Sama, Denis
Ntudhu, Syrus
Okello, Daniel Ayen
Byaruhanga, Raymond
Lukoye, Deus
Kasozi, Samuel
A four-year trend in pulmonary bacteriologically confirmed tuberculosis case detection in Kampala-Uganda
title A four-year trend in pulmonary bacteriologically confirmed tuberculosis case detection in Kampala-Uganda
title_full A four-year trend in pulmonary bacteriologically confirmed tuberculosis case detection in Kampala-Uganda
title_fullStr A four-year trend in pulmonary bacteriologically confirmed tuberculosis case detection in Kampala-Uganda
title_full_unstemmed A four-year trend in pulmonary bacteriologically confirmed tuberculosis case detection in Kampala-Uganda
title_short A four-year trend in pulmonary bacteriologically confirmed tuberculosis case detection in Kampala-Uganda
title_sort four-year trend in pulmonary bacteriologically confirmed tuberculosis case detection in kampala-uganda
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6509788/
https://www.ncbi.nlm.nih.gov/pubmed/31077178
http://dx.doi.org/10.1186/s12890-019-0853-3
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