Evaluation of the burden of unsuspected pulmonary tuberculosis and co-morbidity with non-communicable diseases in sputum producing adult inpatients.
Evaluation of the burden of unsuspected pulmonary tuberculosis and co-morbidity with non-communicable diseases in sputum producing adult inpatients.
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DOI：
10.1371/journal.pone.0040774
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发表时间：
2012
期刊：
影响因子：
3.7
通讯作者：
Zumla A
中科院分区：
文献类型：
--
作者：
Bates M;O'Grady J;Mwaba P;Chilukutu L;Mzyece J;Cheelo B;Chilufya M;Mukonda L;Mumba M;Tembo J;Chomba M;Kapata N;Rachow A;Clowes P;Maeurer M;Hoelscher M;Zumla A
撒哈拉以南非洲国家的结核病负担很高，许多活动性结核病和耐药结核病病例仍未得到诊断。三级保健医院为研究结核病与非传染性疾病和其他传染性疾病（NCDs/CDs）的合并症提供了机会。我们评估了三级转诊中心成年住院患者未确诊肺结核和耐多药结核病的负担，无论其初次入院诊断如何。在这项前瞻性研究中，赞比亚卢萨卡大学教学医院新入院的能够产生痰的成年住院患者使用荧光涂片显微镜和自动液体培养筛查肺结核。确定了肺结核、未确诊结核病、结核病合并非传染性疾病和传染性疾病的负担。对900例（70.6%）HIV感染者、277例（30.8%）非结核疑似患者、286例（31.8%）结核疑似患者和337例（37.4%）已接受结核治疗的住院患者进行痰液分析。202/900例（22.4%）患者培养确诊结核。在20/275（7.3%）非传染性疾病患者中检出结核合并症，与糖尿病显著相关（P = 0.006, OR 6.571, 95%CI: 1.706-25.3）。27/202例（13.4%）结核病例未被怀疑。有18例耐多药结核病确诊病例，其中5例未被怀疑。在非传染性疾病和其他传染性疾病住院患者中，存在着未被怀疑的肺结核合并症的巨大负担。建议在结核病高流行国家的三级转诊中心对所有住院患者进行主动痰液筛查。住院患者中未确诊的耐多药结核病问题的规模需要进一步研究。
A high burden of tuberculosis (TB) occurs in sub-Saharan African countries and many cases of active TB and drug-resistant TB remain undiagnosed. Tertiary care hospitals provide an opportunity to study TB co-morbidity with non-communicable and other communicable diseases (NCDs/CDs). We evaluated the burden of undiagnosed pulmonary TB and multi-drug resistant TB in adult inpatients, regardless of their primary admission diagnosis, in a tertiary referral centre. In this prospective study, newly admitted adult inpatients able to produce sputum at the University Teaching Hospital, Lusaka, Zambia, were screened for pulmonary TB using fluorescent smear microscopy and automated liquid culture. The burden of pulmonary TB, unsuspected TB, TB co-morbidity with NCDs and CDs was determined. Sputum was analysed from 900 inpatients (70.6% HIV infected) 277 (30.8%) non-TB suspects, 286 (31.8%) TB suspects and 337 (37.4%) were already receiving TB treatment. 202/900 (22.4%) of patients had culture confirmed TB. TB co-morbidity was detected in 20/275 (7.3%) NCD patients, significantly associated with diabetes (P = 0.006, OR 6.571, 95%CI: 1.706–25.3). 27/202 (13.4%) TB cases were unsuspected. There were 18 confirmed cases of MDR-TB, 5 of which were unsuspected. A large burden of unsuspected pulmonary TB co-morbidity exists in inpatients with NCDs and other CDs. Pro-active sputum screening of all inpatients in tertiary referral centres in high TB endemic countries is recommended. The scale of the problem of undiagnosed MDR-TB in inpatients requires further study.
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影响因子：
15.8
作者：
Corbett, Elizabeth L.;Bandason, Tsitsi;Cheung, Yin Bun;Munyati, Shungu;Godfrey-Faussett, Peter;Hayes, Richard;Churchyard, Gavin;Butterworth, Anthony;Mason, Peter
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2
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Creswell, J.;Raviglione, M.;Loennroth, K.
通讯作者：
Loennroth, K.
影响因子：
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作者：
Coetzee, D;Hilderbrand, K;Boelaert, M
通讯作者：
Boelaert, M
影响因子：
3.3
作者：
Kapata, Nathan;Chanda-Kapata, Pascalina;Mwaba, Peter
通讯作者：
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