Cough Frequency During Treatment Associated With Baseline Cavitary Volume and Proximity to the Airway in Pulmonary TB

Proaño, Alvaro; Bui, David; López, José W.; Vu, Nancy M.; Bravard, Marjory A.; Lee, Gwenyth O.; Tracey, Brian H.; Xu, Ziyue; Comina, Germán; Ticona, Eduardo; Mollura, Daniel J.; Friedland, Jon S.; Moore, David; Evans, Carlton A.; Caligiuri, Philip; Gilman, Robert H.; Cabrera, Lilia; Varela, Marco Antonio Siles; Vigil-Romani, Francisco; Chacaltana, Jesús; Cabrera, José Luis; Salas, Antonio; Llanos, Félix; Ñavincopa, Marcos; Kirwan, Daniela E.; Datta, Sumona; Rothstein, Jessica D.; Doria, Nicole; Hernández-Córdova, Gustavo; Oberhelman, Richard A.; Coronel, Jorge; Caviedes, Luz; Zimic, Mirko; Oren, Eyal

doi:10.1016/j.chest.2018.03.006

Cited by 16 publications

(9 citation statements)

References 61 publications

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“…More recently a study in Peru found a substantially lower pre-treatment median of 2.3 coughs/hour but replicated the treatment effect on cough frequency with reductions predicting microbiological conversion of sputum [34]. The same group showed a link between greater cough counts as well as persistent coughing on treatment and the presence of larger cavity volumes and proximity of cavities to airways [35]. These findings indicate a correlation between coughing and disease extent but cannot be taken as evidence for cough as a means of transmission.…”

Section: Methodsmentioning

confidence: 99%

Is cough really necessary for TB transmission?

Patterson

Wood

2019

Tuberculosis

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Cough has long been implicated in the production of infectious aerosol leading to transmission of tuberculosis (TB). However, prevalence studies frequently identify radiographic evidence of TB in subclinical individuals in the absence of reported coughing. Elucidating the role of cough in transmission depends on understanding the physical process of aerosolizing and expelling mycobacterium tuberculosis (Mtb) bacilli. In the last decade, human aerosol studies have progressed with improved precision of particle detection and greater sophistication of experimental protocols. Combining principles of respiratory physiology, the site and mechanism of aerosolization of respiratory lining fluids during phases of the respiratory cycle has been investigated in detail. Additionally, recent success in the direct detection of naturally generated Mtb aerosols has allowed more detailed characterization in terms of their rate of production and size distribution. We propose that TB transmission depends on the coincidence of the site of aerosol generation with the presence of Mtb bacilli. This review will examine the evidence for site of aerosol production during cough and respiratory activities in conjunction with the characteristics of detectable Mtb aerosols and locations of tuberculosis infection. Furthermore, we propose respiratory activities that are likely to optimise aerosol sampling for investigation of transmission.

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Section: Methodsmentioning

confidence: 99%

Is cough really necessary for TB transmission?

Patterson

Wood

2019

Tuberculosis

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“…Patients with prior tuberculosis also coughed more. This may be due to more extensive lung damage in these patients [6]. or physiological alterations of the lung that did not fully recover to normality.…”

Section: Plos Onementioning

confidence: 95%

“…Because TOTAL TIME COUGHING was the strongest predictor of TTP, this feature was carried forward to examine determinants of cough severity. Secondarily, because we have previously reported on the association between COUGH EPISODE FREQUENCY and patient characteristics in a separate cohort of HIV-negative Peruvian patients with drug-sensitive tuberculosis [5,6,13], bivariable and multivariable incidence rate ratios comparing COUGH EPISODE FREQUENCY based on clinical characteristics from treatment day 0 to 60 (n = 357) are also reported. TOTAL TIME COUGHING was significantly positively associated with: diabetes (β = 0.86, 95% CI: 0.09, 1.63, p = 0.028); history of prior tuberculosis (β = 1.44, 95% CI: 0.66, 2.22, p<0.001) but not HIV status nor drug resistant tuberculosis.…”

Section: Determinants Of Cough Severitymentioning

confidence: 99%

“…From the clinical perspective, cough is critical both in diagnosis [4] and to monitor treatment response. Recently, it has been shown that cough frequency is associated with sputum bacillary load [5], and with the extent of cavitary lung disease [6]. Cough is also uniquely relevant for the transmission of tuberculosis [7].…”

Section: Introductionmentioning

confidence: 99%

“…Despite the major role that cough plays in tuberculosis transmission, clinical management, and patient experience, relatively few studies have objectively described cough among patients with tuberculosis, in part due to logistical challenges in measuring and characterizing cough. Recently, we reported the development of an audio-based device [10][11][12] to measure cough frequency among HIV-negative Peruvian patients with drug-susceptible tuberculosis disease [5,6,13]. Although this device is non-invasive and capable of generating 24-hour cough recordings, the approach had some limitations.…”

Section: Introductionmentioning

confidence: 99%

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Cough dynamics in adults receiving tuberculosis treatment

et al. 2020

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Cough is a characteristic symptom of tuberculosis, is the main cause of transmission, and is used to assess treatment response. We aimed to identify the best measure of cough severity and characterize changes during initial tuberculosis therapy. We conducted a prospective cohort of recently diagnosed ambulatory adult patients with pulmonary tuberculosis in two tertiary hospitals in Lima, Peru. Pre-treatment and five times during the first two months of treatment, a vibrometer was used to capture 4-hour recordings of involuntary cough. A total of 358 recordings from 69 participants were analyzed using a computer algorithm. Total time spent coughing (seconds per hour) was a better predictor of microbiologic indicators of disease severity and treatment response than the frequency of cough episodes or cough power. Patients with prior tuberculosis tended to cough more than patients without prior tuberculosis, and patients with tuberculosis and diabetes coughed more than patients without diabetes comorbidity. Cough characteristics were similar regardless of HIV co-infection and for drug-susceptible versus drug-resistant tuberculosis. Tuberculosis treatment response may be meaningfully assessed by objectively monitoring the time spent coughing. This measure demonstrated that cough was increased in patients with TB recurrence or co-morbid diabetes, but not because of drug resistance or HIV co-infection.

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Cough in pulmonary tuberculosis: Existing knowledge and general insights

Turner

2019

Pulmonary Pharmacology & Therapeutics

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Cough Frequency During Treatment Associated With Baseline Cavitary Volume and Proximity to the Airway in Pulmonary TB

Abstract: Cough frequency during treatment is greater and lasts longer in patients with larger cavities, especially those closer to the airway.

Cited by 16 publications

References 61 publications

Is cough really necessary for TB transmission?

Is cough really necessary for TB transmission?

Cough dynamics in adults receiving tuberculosis treatment

Cough in pulmonary tuberculosis: Existing knowledge and general insights

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