SETTING: A prison (1171 male inmates) in Rio de Janeiro, Brazil. OBJECTIVES: To determine the prevalence of active pulmonary tuberculosis (TB) and to assess the performance of several screening strategies. DESIGN: In a cross-sectional study, all inmates underwent chest radiographic screening. Subjects with abnormal findings underwent sputum smear examination and sputum culture. Taking this strategy as the reference, we assessed three targeted screening strategies to identify TB suspects: Strategy 1: cough >3 weeks; Strategy 2: WHO score > or = 5; Strategy 3: presence of at least one potentially TB-related symptom. RESULTS: The prevalence of TB cases was 4.6% (48/1052) and 2.7% for definite TB cases. If TB suspects identified by targeted screening had sputum smear examination alone, 37 (86.0%) of the 43 cases would have been missed by Strategy 1, 34/43 (79.1%) by Strategy 2 and 34/43 (79.1%) by Strategy 3. If TB suspects had both sputum smear examination and, for smear-negative subjects, chest radiography, respectively 28/43 (65.1%), 18/43 (41.9%) and 13/43 (30.2%) of cases would have been missed. CONCLUSION: All three targeted screening strategies were unreliable. Given the importance of early TB diagnosis in overcrowded and highly endemic settings, routine radiography-based screening may be warranted.
SETTING: A prison (1171 male inmates) in Rio de Janeiro, Brazil. OBJECTIVES: To determine the prevalence of active pulmonary tuberculosis (TB) and to assess the performance of several screening strategies. DESIGN: In a cross-sectional study, all inmates underwent chest radiographic screening. Subjects with abnormal findings underwent sputum smear examination and sputum culture. Taking this strategy as the reference, we assessed three targeted screening strategies to identify TB suspects: Strategy 1: cough >3 weeks; Strategy 2: WHO score > or = 5; Strategy 3: presence of at least one potentially TB-related symptom. RESULTS: The prevalence of TB cases was 4.6% (48/1052) and 2.7% for definite TB cases. If TB suspects identified by targeted screening had sputum smear examination alone, 37 (86.0%) of the 43 cases would have been missed by Strategy 1, 34/43 (79.1%) by Strategy 2 and 34/43 (79.1%) by Strategy 3. If TB suspects had both sputum smear examination and, for smear-negative subjects, chest radiography, respectively 28/43 (65.1%), 18/43 (41.9%) and 13/43 (30.2%) of cases would have been missed. CONCLUSION: All three targeted screening strategies were unreliable. Given the importance of early TB diagnosis in overcrowded and highly endemic settings, routine radiography-based screening may be warranted.
Authors: Paulo César Pereira Dos Santos; Andrea da Silva Santos; Roberto Dias de Oliveira; Bruna Oliveira da Silva; Thiego Ramon Soares; Leonardo Martinez; Renu Verma; Jason R Andrews; Julio Croda Journal: Clin Infect Dis Date: 2022-07-06 Impact factor: 20.999
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Authors: Ingunn Harstad; Geir W Jacobsen; Einar Heldal; Brita A Winje; Saeed Vahedi; Anne-Sofie Helvik; Sigurd L Steinshamn; Helge Garåsen Journal: BMC Public Health Date: 2010-11-04 Impact factor: 3.295
Authors: Lilanganee Telisinghe; Salome Charalambous; Stephanie M Topp; Michael E Herce; Christopher J Hoffmann; Peter Barron; Erik J Schouten; Andreas Jahn; Rony Zachariah; Anthony D Harries; Chris Beyrer; Joseph J Amon Journal: Lancet Date: 2016-07-14 Impact factor: 79.321
Authors: Katharina Kranzer; Rein Mgj Houben; Judith R Glynn; Linda-Gail Bekker; Robin Wood; Stephen D Lawn Journal: Lancet Infect Dis Date: 2010-02 Impact factor: 25.071
Authors: Isabel M Prellwitz; Brunna M Alves; Maria Letícia R Ikeda; Daniele Kuhleis; Pedro D Picon; Carla A Jarczewski; Marta R Osório; Alexandra Sánchez; Héctor N Seuánez; Bernard Larouzé; Marcelo A Soares; Esmeralda A Soares Journal: PLoS One Date: 2013-07-09 Impact factor: 3.240