M S Sander1, C Y Vuchas2, H N Numfor2, A N Nsimen2, J-L F Abena3, J Noeske4, A Van Deun5, K L Morgan6. 1. Tuberculosis Reference Laboratory Bamenda, Bamenda, Cameroon; German International Cooperation, Yaounde, Cameroon. 2. Tuberculosis Reference Laboratory Bamenda, Bamenda, Cameroon. 3. National Tuberculosis Control Programme, Yaounde, Cameroon. 4. Independent Consultant, Yaounde, Cameroon. 5. Mycobacteriology Unit, Institute of Tropical Medicine, Antwerp, Belgium; International Union Against Tuberculosis and Lung Disease, Paris, France. 6. Institute of Ageing and Chronic Disease and School of Veterinary Science, University of Liverpool, Leahurst, UK.
Abstract
BACKGROUND: Rapid and effective diagnosis of multidrug-resistant tuberculosis (MDR-TB) is an essential component of global tuberculosis (TB) control, but most MDR-TB cases are still not diagnosed. OBJECTIVE: To assess whether patient sputum bacterial load can be used to identify patients at increased risk of MDR-TB. METHODS: We used a case-control study and multivariable logistic regression models to investigate associations between MDR-TB and sputum bacterial load, as measured by semi-quantitative microscopy and automated time to detection (TTD) of liquid culture. We assessed data from retreatment TB patients with MDR-TB (cases) and from those without MDR-TB (controls) at a reference laboratory in Cameroon. RESULTS: MDR-TB was associated with a smear microscopy grade of 3+ (OR 21.9, 95%CI 6.2-76.8) or 2+ (OR 10.8, 95%CI 2.9-40.7), compared to a result of 1+, scanty or smear-negative among 80 MDR-TB cases and 521 controls. MDR-TB was associated with automated TTD of ⩿160 h (OR 2.2, 95%CI 1.1-4.7) compared to >160 h among a subpopulation of 47 cases and 350 controls. CONCLUSIONS: A higher sputum bacterial load is associated with MDR-TB in retreatment patients in Cameroon.
BACKGROUND: Rapid and effective diagnosis of multidrug-resistant tuberculosis (MDR-TB) is an essential component of global tuberculosis (TB) control, but most MDR-TB cases are still not diagnosed. OBJECTIVE: To assess whether patient sputum bacterial load can be used to identify patients at increased risk of MDR-TB. METHODS: We used a case-control study and multivariable logistic regression models to investigate associations between MDR-TB and sputum bacterial load, as measured by semi-quantitative microscopy and automated time to detection (TTD) of liquid culture. We assessed data from retreatment TB patients with MDR-TB (cases) and from those without MDR-TB (controls) at a reference laboratory in Cameroon. RESULTS: MDR-TB was associated with a smear microscopy grade of 3+ (OR 21.9, 95%CI 6.2-76.8) or 2+ (OR 10.8, 95%CI 2.9-40.7), compared to a result of 1+, scanty or smear-negative among 80 MDR-TB cases and 521 controls. MDR-TB was associated with automated TTD of ⩿160 h (OR 2.2, 95%CI 1.1-4.7) compared to >160 h among a subpopulation of 47 cases and 350 controls. CONCLUSIONS: A higher sputum bacterial load is associated with MDR-TB in retreatment patients in Cameroon.
Authors: Trinh T B Tram; Hoang N Nhung; Srinivasan Vijay; Hoang T Hai; Do D A Thu; Vu T N Ha; Tran D Dinh; Philip M Ashton; Nguyen T Hanh; Nguyen H Phu; Guy E Thwaites; Nguyen T T Thuong Journal: Front Cell Infect Microbiol Date: 2018-11-27 Impact factor: 5.293
Authors: Joseph Baruch Baluku; Pallen Mugabe; Rose Mulwana; Sylvia Nassozi; Richard Katuramu; William Worodria Journal: Biomed Res Int Date: 2020-07-25 Impact factor: 3.411