Sputum, sex and scanty smears: new case definition may reduce sex disparities in smear-positive tuberculosis

Hdl Handle:
http://hdl.handle.net/10144/114023
Title:
Sputum, sex and scanty smears: new case definition may reduce sex disparities in smear-positive tuberculosis
Authors:
Ramsay, A; Bonnet, M; Gagnidze, L; Githui, W; Varaine, F; Guérin, P J
Journal:
International Journal of Tuberculosis and Lung Disease
Abstract:
SETTING: Urban clinic, Nairobi. OBJECTIVES: To evaluate the impact of specimen quality and different smear-positive tuberculosis (TB) case (SPC) definitions on SPC detection by sex. DESIGN: Prospective study among TB suspects. RESULTS: A total of 695 patients were recruited: 644 produced > or =1 specimen for microscopy. The male/female sex ratio was 0.8. There were no significant differences in numbers of men and women submitting three specimens (274/314 vs. 339/380, P = 0.43). Significantly more men than women produced a set of three 'good' quality specimens (175/274 vs. 182/339, P = 0.01). Lowering thresholds for definitions to include scanty smears resulted in increases in SPC detection in both sexes; the increase was significantly higher for women. The revised World Health Organization (WHO) case definition was associated with the highest detection rates in women. When analysis was restricted only to patients submitting 'good' quality specimen sets, the difference in detection between sexes was on the threshold for significance (P = 0.05). CONCLUSIONS: Higher SPC notification rates in men are commonly reported by TB control programmes. The revised WHO SPC definition may reduce sex disparities in notification. This should be considered when evaluating other interventions aimed at reducing these. Further study is required on the effects of the human immuno-deficiency virus and instructed specimen collection on sex-specific impact of new SPC definition.
Affiliation:
Liverpool School of Tropical Medicine, Liverpool, UK; Epicentre, Paris, France; Kenya Medical Research Institute, Nairobi, Kenya; Médecins Sans Frontières, Paris, France
Issue Date:
1-May-2009
URI:
http://hdl.handle.net/10144/114023
PubMed ID:
19383195
Additional Links:
http://www.ingentaconnect.com/content/iuatld/ijtld/2009/00000013/00000005/art00015?token=004f1be27d767b0a12c5a666f3a7b6c24316a763b6b746658662a49264f65263a3d4f58762f46fc
Type:
Article
Language:
en
ISSN:
1027-3719
Appears in Collections:
TB

Full metadata record

DC FieldValue Language
dc.contributor.authorRamsay, Aen
dc.contributor.authorBonnet, Men
dc.contributor.authorGagnidze, Len
dc.contributor.authorGithui, Wen
dc.contributor.authorVaraine, Fen
dc.contributor.authorGuérin, P Jen
dc.date.accessioned2010-10-29T15:53:09Z-
dc.date.available2010-10-29T15:53:09Z-
dc.date.issued2009-05-01-
dc.identifier.citationInt. J. Tuberc. Lung Dis. 2009;13(5):613-9en
dc.identifier.issn1027-3719-
dc.identifier.pmid19383195-
dc.identifier.urihttp://hdl.handle.net/10144/114023-
dc.description.abstractSETTING: Urban clinic, Nairobi. OBJECTIVES: To evaluate the impact of specimen quality and different smear-positive tuberculosis (TB) case (SPC) definitions on SPC detection by sex. DESIGN: Prospective study among TB suspects. RESULTS: A total of 695 patients were recruited: 644 produced > or =1 specimen for microscopy. The male/female sex ratio was 0.8. There were no significant differences in numbers of men and women submitting three specimens (274/314 vs. 339/380, P = 0.43). Significantly more men than women produced a set of three 'good' quality specimens (175/274 vs. 182/339, P = 0.01). Lowering thresholds for definitions to include scanty smears resulted in increases in SPC detection in both sexes; the increase was significantly higher for women. The revised World Health Organization (WHO) case definition was associated with the highest detection rates in women. When analysis was restricted only to patients submitting 'good' quality specimen sets, the difference in detection between sexes was on the threshold for significance (P = 0.05). CONCLUSIONS: Higher SPC notification rates in men are commonly reported by TB control programmes. The revised WHO SPC definition may reduce sex disparities in notification. This should be considered when evaluating other interventions aimed at reducing these. Further study is required on the effects of the human immuno-deficiency virus and instructed specimen collection on sex-specific impact of new SPC definition.en
dc.language.isoenen
dc.relation.urlhttp://www.ingentaconnect.com/content/iuatld/ijtld/2009/00000013/00000005/art00015?token=004f1be27d767b0a12c5a666f3a7b6c24316a763b6b746658662a49264f65263a3d4f58762f46fcen
dc.rightsArchived with thanks to The International Journal of Tuberculosis and Lung Disease : the official journal of the International Union against Tuberculosis and Lung Diseaseen
dc.subject.meshAdulten
dc.subject.meshCytodiagnosisen
dc.subject.meshDiagnosis, Differentialen
dc.subject.meshFemaleen
dc.subject.meshHumansen
dc.subject.meshKenyaen
dc.subject.meshMaleen
dc.subject.meshMicroscopyen
dc.subject.meshMycobacterium tuberculosisen
dc.subject.meshPrevalenceen
dc.subject.meshProspective Studiesen
dc.subject.meshSex Distributionen
dc.subject.meshSex Factorsen
dc.subject.meshSputumen
dc.subject.meshTuberculosisen
dc.titleSputum, sex and scanty smears: new case definition may reduce sex disparities in smear-positive tuberculosisen
dc.typeArticleen
dc.contributor.departmentLiverpool School of Tropical Medicine, Liverpool, UK; Epicentre, Paris, France; Kenya Medical Research Institute, Nairobi, Kenya; Médecins Sans Frontières, Paris, Franceen
dc.identifier.journalInternational Journal of Tuberculosis and Lung Diseaseen

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