SETTING: Bandim Health Project, Bissau, Guinea-Bissau. OBJECTIVE: To conduct tuberculosis (TB) screening among former TB suspects in whom TB had been ruled out on initial consultation and therefore assumed to be TB-negative (aTBneg). DESIGN: In a cohort follow-up study, 'aTBneg suspects' were screened for symptoms from 1 month after the initial negative sputum smear examination. Symptomatic individuals were referred for clinical re-examination and human immunodeficiency virus (HIV) testing. RESULTS: Among 428 TB suspects presenting over a 10-month period in 2007, 80% (343) were smear-negative. Of these, 21 were subsequently diagnosed with smear-negative TB. Of the remaining 322 aTBneg patients, 212 were followed up and symptoms were examined ≥1 month after initial examination. Among followed up patients, 89 (42%) were still symptomatic: five were diagnosed with TB on the basis of repeated sputum smears and chest X-ray. Of 44 symptomatic patients, 39% (n = 17) were HIV-infected. Thirteen (4%) of the 322 aTBneg suspects died before follow-up. CONCLUSION: A large proportion of aTBneg patients remained symptomatic after 1 month. Several TB cases had initially not been diagnosed, and HIV infection was highly prevalent. aTBneg suspects have a high mortality rate and need increased attention from both TB and HIV programmes.
SETTING: Bandim Health Project, Bissau, Guinea-Bissau. OBJECTIVE: To conduct tuberculosis (TB) screening among former TB suspects in whom TB had been ruled out on initial consultation and therefore assumed to be TB-negative (aTBneg). DESIGN: In a cohort follow-up study, 'aTBneg suspects' were screened for symptoms from 1 month after the initial negative sputum smear examination. Symptomatic individuals were referred for clinical re-examination and human immunodeficiency virus (HIV) testing. RESULTS: Among 428 TB suspects presenting over a 10-month period in 2007, 80% (343) were smear-negative. Of these, 21 were subsequently diagnosed with smear-negative TB. Of the remaining 322 aTBneg patients, 212 were followed up and symptoms were examined ≥1 month after initial examination. Among followed up patients, 89 (42%) were still symptomatic: five were diagnosed with TB on the basis of repeated sputum smears and chest X-ray. Of 44 symptomatic patients, 39% (n = 17) were HIV-infected. Thirteen (4%) of the 322 aTBneg suspects died before follow-up. CONCLUSION: A large proportion of aTBneg patients remained symptomatic after 1 month. Several TB cases had initially not been diagnosed, and HIV infection was highly prevalent. aTBneg suspects have a high mortality rate and need increased attention from both TB and HIV programmes.
Authors: Khine Wut Yee Kyaw; Nang Thu Thu Kyaw; Myo Su Kyi; Sandar Aye; Anthony D Harries; Ajay M V Kumar; Nay Lynn Oo; Srinath Satyanarayana; Si Thu Aung Journal: PLoS One Date: 2020-06-18 Impact factor: 3.240
Authors: Grace Lui; Rity Y K Wong; Florence Li; May K P Lee; Raymond W M Lai; Timothy C M Li; Joseph K M Kam; Nelson Lee Journal: PLoS One Date: 2014-03-18 Impact factor: 3.240
Authors: Ajay Mv Kumar; Devesh Gupta; Ashok Kumar; R S Gupta; Avinash Kanchar; Raghuram Rao; Suresh Shastri; M D Suryakanth; Chethana Rangaraju; Balaji Naik; Deepak K Guddemane; Prashant Bhat; Achuthan Sreenivas Nair; Anthony David Harries; Puneet Dewan Journal: PLoS One Date: 2016-05-31 Impact factor: 3.240
Authors: Ajay M V Kumar; Anil Singarajipura; Balaji Naik; Deepak K Guddemane; Yogesh Patel; Suresh Shastri; Sunil Kumar; Rajesh Deshmukh; B B Rewari; Anthony David Harries Journal: J Epidemiol Glob Health Date: 2016-01-25