Same-day smears in the diagnosis of tuberculosis

Trop Med Int Health. 2007 Dec;12(12):1459-63. doi: 10.1111/j.1365-3156.2007.01952.x.

Abstract

Objective: To assess the feasibility of completing the diagnosis of tuberculosis (TB) in 1 day by collecting only on-the-spot specimens.

Methods: Individuals with suspected TB attending district hospitals in Abuja submitted three sputum samples for routine diagnosis (the standard approach). One additional sample was collected 1 h after the first sputum (the same-day approach). One sputum sample was cultured. Blood samples were tested for HIV.

Results: Two hundred and twenty-four patients with chronic cough had 135/672 (20%) positive on-the-spot smears and 47/224 (21%) positive morning smears. The same-day and internationally recommended approaches identified 44 and 45 of the 78 patients with positive cultures, respectively. 106/194 (55%) patients were HIV positive. Only 9-11% of their smears were positive compared with 30-32% for HIV negatives (P < 0.01).

Conclusion: It could be possible to diagnose TB in a single day by examining two spot specimens, but the feasibility needs to be confirmed on a larger scale.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Cross-Sectional Studies
  • Feasibility Studies
  • Female
  • HIV Seropositivity / blood
  • Humans
  • Male
  • Middle Aged
  • Nigeria / epidemiology
  • Sputum / microbiology*
  • Time Factors
  • Tuberculosis / diagnosis*
  • Tuberculosis / epidemiology