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Duration of cough, TB suspects' characteristics and service factors determine the yield of smear microscopy

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dc.contributor.author Otero, L.
dc.contributor.author Ugaz, R.
dc.contributor.author Dieltiens, G.
dc.contributor.author Gonzalez, E.
dc.contributor.author Verdonck, K.
dc.contributor.author Seas, C.
dc.contributor.author Van Deun, A.
dc.contributor.author Gotuzzo, E.
dc.contributor.author Van der Stuyft, P.
dc.date.accessioned 2010-12-17T13:37:46Z
dc.date.available 2010-12-17T13:37:46Z
dc.date.issued 2010
dc.identifier.issn 1360-2276
dc.identifier.doi http://dx.doi.org/10.1111/j.1365-3156.2010.02645.x
dc.identifier.other ITG-H3B
dc.identifier.other ITG-M5A
dc.identifier.other ITG-M7A
dc.identifier.other ITG-HLA
dc.identifier.other MULTI
dc.identifier.other HEALTH
dc.identifier.other U-EPID
dc.identifier.other MICRO
dc.identifier.other U-MYCOB
dc.identifier.other JIF
dc.identifier.other DOI
dc.identifier.other FTB
dc.identifier.other Abstract
dc.identifier.other UPD28
dc.identifier.uri http://hdl.handle.net/10390/6396
dc.description.abstract Objective To determine the efficiency of routine tuberculosis (TB) case detection by examining sputum smear positivity for acid-fast bacilli in relation to duration of cough, characteristics of TB suspects examined and health service factors. Method We combined patient interviews with routine data from laboratory registers in 6 health care facilities in San Juan de Lurigancho district, Lima, Peru. A TB case was defined as a TB suspect with at least one positive sputum smear. We calculated adjusted odds ratios with 95% confidence intervals for the association between smear positivity and health service and patient's characteristics. Results Smear positivity was 7.3% (321/4376). Of the 4376 adults submitting sputa, 55.3% (2418) reported cough for <14 days. In this group, smear microscopy yielded 3.2% (78/2418) positive results vs. 12.4% (243/1958) in patients coughing for 14 or more days. Having cough for >2 weeks, being referred by health care staff, attending a secondary-level health care facility, male sex and age between 15 and 44 years were independent determinants of smear positivity. Conclusions Routine case detection yields a low proportion of smear-positive cases because of the inclusion of a high proportion of patients without cough or coughing for <2 weeks. Adherence to the national TB control programme guidelines on the selection of TB suspects would have a positive impact on the smear positivity rate, reduce laboratory costs and workload and possibly improve the reading quality of smear microscopy en
dc.language English en
dc.subject Bacterial diseases en
dc.subject Tuberculosis en
dc.subject Mycobacterium tuberculosis en
dc.subject Case detection en
dc.subject Efficiency en
dc.subject Examination en
dc.subject Sputum microscopy en
dc.subject Smear-positive en
dc.subject Acid-fast bacilli en
dc.subject Associations en
dc.subject Determinants en
dc.subject Duration en
dc.subject Cough en
dc.subject Signs and symptoms en
dc.subject Referral en
dc.subject Peru en
dc.subject America, Latin en
dc.title Duration of cough, TB suspects' characteristics and service factors determine the yield of smear microscopy en
dc.type Article en
dc.citation.issue 12 en
dc.citation.jtitle Tropical Medicine and International Health en
dc.citation.volume 15 en
dc.citation.pages 1475-1480 en
dc.identifier.pmid http://www.ncbi.nlm.nih.gov/pubmed/21087375
dc.citation.jabbreviation Trop Med Int Health en


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