Skip to content
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Menu
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Menu
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Sputum microscopy for the diagnosis of HIV-associated pulmonary tuberculosis in Tanzania
BMC Public Health, Volume 8, Article 68, Year 2008
Notification
URL copied to clipboard!
Description
Background. In many resource poor settings only sputum microscopy is employed for the diagnosis of HIV-associated pulmonary tuberculosis; sputum culture may not be available. Methods. We determined the diagnostic accuracy of sputum microscopy for active case finding of HIV-associated pulmonary tuberculosis using TB culture as the reference standard. Results. 2216 potential subjects screened for a TB vaccine trial submitted 9454 expectorated sputum specimens: 212 (2.2%) were sputum culture positive for Mycobacterium tuberculosis (MTB), 31 (0.3%) for non-tuberculous mycobacteria, and 79 (0.8%) were contaminated. The overall sensitivity of sputum microscopy was 61.8% (131/212) and specificity 99.7% (9108/9132). Sputum microscopy sensitivity varied from 22.6% in specimens with < 20 colony forming units (CFU)/specimen to 94.2% in patients with > 100 CFU/specimen plus confluent growth. The incremental diagnostic value for sputum microscopy was 92.1%, 1.8% and 7.1% for the first, second and third specimens, respectively. The positive predictive value and negative predictive values for sputum microscopy were 84.5% and 99.1%, respectively. The likelihood ratio (LR) of a positive sputum microscopy was 235.1 (95% CI 155.8 - 354.8), while the LR of a negative test was 0.38 (95CI 0.32 - 0.45). The 212 positive sputum cultures for MTB represented 103 patients; sputum microscopy was positive for 57 (55.3%) of 103 patients. Conclusion. Sputum microscopy on 3 expectorated sputum specimens will only detect 55% of culture positive HIV-infected patients in active screening for pulmonary tuberculosis. Sensitivity is higher in patients with greater numbers of CFUs in the sputum. Culture is required for active case finding of HIV- associated pulmonary tuberculosis. © 2008 Matee et al; licensee BioMed Central Ltd.
Authors & Co-Authors
Matee, Mecky Isaac N.
Tanzania, Dar es Salaam
Muhimbili University of Health and Allied Sciences
Mtei, Lillian N.
Tanzania, Dar es Salaam
Muhimbili University of Health and Allied Sciences
Lounasvaara, Tarja
Finland, Helsinki
Terveyden ja Hyvinvoinnin Laitos
Wieland-Alter, Wendy
United States, Hanover
Geisel School of Medicine at Dartmouth
Waddell, R.
United States, Hanover
Geisel School of Medicine at Dartmouth
Lyimo, Johnson J.
Tanzania, Dar es Salaam
Muhimbili University of Health and Allied Sciences
Bakari, Muhammad
Tanzania, Dar es Salaam
Muhimbili University of Health and Allied Sciences
Pallangyo, Kisali J.
Tanzania, Dar es Salaam
Muhimbili University of Health and Allied Sciences
von Reyn, Charles Fordham
United States, Hanover
Geisel School of Medicine at Dartmouth
Statistics
Citations: 56
Authors: 9
Affiliations: 3
Identifiers
Doi:
10.1186/1471-2458-8-68
e-ISSN:
14712458
Research Areas
Infectious Diseases
Study Locations
Tanzania