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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Infrequent detection of Pneumocystis jirovecii by PCR in oral wash specimens from TB patients with or without HIV and healthy contacts in Tanzania
BMC Infectious Diseases, Volume 10, Article 140, Year 2010
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Description
Background: In tuberculosis (TB) endemic parts of the world, patients with pulmonary symptoms are managed as "smear-negative TB patients" if they do not improve on a two-week presumptive, broad-spectrum course of antibiotic treatment even if they are TB microscopy smear negative. These patients are frequently HIV positive and have a higher mortality than smear-positive TB patients. Lack of access to diagnose Pneumocystis jirovecii pneumonia might be a contributing reason. We therefore assessed the prevalence of P. jirovecii by PCR in oral wash specimens among TB patients and healthy individuals in an HIV- and TB-endemic area of sub-Saharan Africa.Methods: A prospective study of 384 patients initiating treatment for sputum smear-positive and smear-negative TB and 100 healthy household contacts and neighbourhood controls.DNA from oral wash specimens was examined by PCR for P. jirovecii. All patients delivered sputum for TB microscopy and culture. Healthy contacts and community controls were clinically assessed and all study subjects were HIV tested and had CD4 cell counts determined. Clinical status and mortality was assessed after a follow-up period of 5 months.Results: 384 patients and 100 controls were included, 53% and 8% HIV positive respectively. A total number of 65 patients and controls (13.6%) were at definitive risk for PCP based on CD4 counts <200 cells per mm3 and no specific PCP prophylaxis. Only a single patient (0.3% of the patients) was PCR positive for P. jirovecii. None of the healthy household contacts or neighbourhood controls had PCR-detectable P. jirovecii DNA in their oral wash specimens regardless of HIV-status.Conclusions: The prevalence of P. jirovecii as detected by PCR on oral wash specimens was very low among TB patients with or without HIV and healthy individuals in Tanzania. Colonisation by P. jirovecii was not detected among healthy controls. The present findings may encourage diagnostic use of this non-invasive method. © 2010 Jensen et al; licensee BioMed Central Ltd.
Authors & Co-Authors
Jensen, Lotte
Denmark, Copenhagen
Rigshospitalet
Vestergaard-Jensen, Andreas
Denmark, Copenhagen
Rigshospitalet
PrayGod, George
Tanzania, Tanga
National Institute for Medical Research Tanga
Jeremiah, Kidola
Tanzania, Tanga
National Institute for Medical Research Tanga
Faurholt-Jepsen, Daniel
Denmark, Copenhagen
Københavns Universitet
Changalucha, John M.
Tanzania, Tanga
National Institute for Medical Research Tanga
Range, Nyagosya Segere
Tanzania, Tanga
National Institute for Medical Research Tanga
Friis, Henrik M.U.
Denmark, Copenhagen
Københavns Universitet
Helweg-Larsen, Jannik
Denmark, Copenhagen
Rigshospitalet
Jensen, Jörgen Skov
Denmark, Copenhagen
Statens Serum Institut
Andersen, Aase Bengaard
Denmark, Copenhagen
Rigshospitalet
Statistics
Citations: 21
Authors: 11
Affiliations: 4
Identifiers
Doi:
10.1186/1471-2334-10-140
e-ISSN:
14712334
Research Areas
Genetics And Genomics
Health System And Policy
Infectious Diseases
Study Design
Cross Sectional Study
Cohort Study
Study Locations
Tanzania