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    Apr 11, 2021
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    Sputum, sex and scanty smears: new case definition may reduce sex disparities in smear-positive tuberculosis

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    Authors
    Ramsay, A
    Bonnet, M
    Gagnidze, L
    Githui, W
    Varaine, F
    Guérin, P J
    Affiliation
    Liverpool School of Tropical Medicine, Liverpool, UK; Epicentre, Paris, France; Kenya Medical Research Institute, Nairobi, Kenya; Médecins Sans Frontières, Paris, France
    Issue Date
    2009-05-01
    
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    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.
    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
    Collections
    TB

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