Delay in the diagnosis of pulmonary tuberculosis in The Gambia, West Africa: A cross-sectional study

Owolabi, Olumuyiwa; Jallow, Amadou T.; Jallow, Momodou W.; Sowe, Gambia; Jallow, Rohey; Genekah, Monica Davies; Donkor, Simon; Wurrie, Alieu; Kampmann, Beate; Sutherland, Jayne S.; Togun, Toyin

doi:10.1016/j.ijid.2020.09.029

Cited by 27 publications

(33 citation statements)

References 23 publications

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“…Older patients and women in this part of the world generally depend on others, so it can be challenging for them to seek medical care when necessary. However, similar to our study, a systematic review of 45 studies from Asia stated that older age and females are strongly associated with delays in the diagnosis of TB [11,[56][57]. Females' tendency to delay has been attributed to their restricted socio-cultural environment in Pakistan, decision-making power, the burden of domestic works, illiteracy, and distance from health care centres [58].…”

Section: Discussionsupporting

confidence: 81%

“…In passive case finding, people with probable TB come to a public health facility and are investigated for TB and the initiative comes from patients [10]. Due to this passive case detection, many factors contributed to the delay in the diagnosis and treatment of TB, including poor socioeconomic status, awareness of symptoms of TB, living in poor hygiene conditions, social stigma, disease, access to health facilities, and situations of displacement emergencies [11]. Another challenge to TB control is that multiple socioeconomic, cultural, environmental and political factors underpin the recent increase in human migration in developing nations [12].…”

Section: Introductionmentioning

confidence: 99%

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Impact of Protracted Displacement on Delay in the Diagnosis Associated with Treatment Outcomes: A Cross-sectional Study in Internally Displaced Tuberculosis Patients of Pakistan

Khan¹,

Khan²,

Hayat³

et al. 2021

Preprint

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Human displacement is on the rise globally, and the increase in the burden of tuberculosis (TB) is also attributed to migrations worldwide. A significant number of such displacement occur in regions with considerably higher areas of TB burden. Displacements may delay in TB diagnosis and treatment, which possibly will lead to TB transmission among healthy individuals. In this study, we assessed the association of existing determinants after a protracted internal displacement of people with the delay in TB diagnosis and treatment outcomes. A cross-sectional study was conducted on internally displaced TB patients registered at selected health facilities in three urban districts of Pakistan from March 2019 to February 2020. The univariate and multivariate logistic regression model was used to assess the delay in diagnosis and treatment outcomes. IDPs with delay in initiation of treatment beyond 30 days were at high possibility of unsuccessful TB treatment outcomes (adjusted odds ratio AOR,2.60; 95% CI 1.06-6.40). Analysis of factors that affect health seeker behavior and timely treatment showed a significant association (p<0.05) in-between age group 55-65 years (AOR, 2.66; 95% CI 1.00-7.07), female patients (AOR, 2.42; 95% CI 1.21-4.81), visited non-formal health provider (AOR, 8.81; 95% CI 3.99-19.46), self-medication (AOR, 2.72; 95 % CI 1.37-5.37), poor knowledge of TB (AOR, 11.39; 95% CI 3.31-39.1), and perceived stigma (AOR, 8.81; 95% CI 3.99-19.4). Prolong delay in treatment was associated with unfavorable treatment outcomes among IDPs, more specifically. As migrants and IDPs are more likely to experience an interruption in care due to overall exclusion from social and health care services. Therefore, it is imperative to understand the barriers in providing public health care services, particularly in preventing and treating TB.

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Section: Discussionsupporting

confidence: 81%

Section: Introductionmentioning

confidence: 99%

Impact of Protracted Displacement on Delay in the Diagnosis Associated with Treatment Outcomes: A Cross-sectional Study in Internally Displaced Tuberculosis Patients of Pakistan

Khan¹,

Khan²,

Hayat³

et al. 2021

Preprint

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“…The TB continues relentlessly, especially during the current global COVID-19 pandemic, killing more than other infection, while the progress being lagging behind other major infectious diseases (34)(35)(36)(37)(38). A fundamental issue with controlling the disease is the inadequacy of current available tests for stratification of status of MTB infection (39).…”

Section: Discussionmentioning

confidence: 99%

Lymphocyte Non-Specific Function Detection Facilitating the Stratification of Mycobacterium tuberculosis Infection

et al. 2021

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BackgroundInadequate tuberculosis (TB) diagnostics, especially for discrimination between active TB (ATB) and latent TB infection (LTBI), are major hurdle in the reduction of the disease burden. The present study aims to investigate the role of lymphocyte non-specific function detection for TB diagnosis in clinical practice.MethodsA total of 208 participants including 49 ATB patients, 64 LTBI individuals, and 95 healthy controls were recruited at Tongji hospital from January 2019 to October 2020. All subjects were tested with lymphocyte non-specific function detection and T-SPOT assay.ResultsSignificantly positive correlation existed between lymphocyte non-specific function and phytohemagglutinin (PHA) spot number. CD4+ T cell non-specific function showed the potential for differentiating patients with negative T-SPOT results from those with positive T-SPOT results with an area under the curve (AUC) of 0.732 (95% CI, 0.572-0.893). The non-specific function of CD4+ T cells, CD8+ T cells, and NK cells was found significantly lower in ATB patients than in LTBI individuals. The AUCs presented by CD4+ T cell non-specific function, CD8+ T cell non-specific function, and NK cell non-specific function for discriminating ATB patients from LTBI individuals were 0.845 (95% CI, 0.767-0.925), 0.770 (95% CI, 0.683-0.857), and 0.691 (95% CI, 0.593-0.789), respectively. Application of multivariable logistic regression resulted in the combination of CD4+ T cell non-specific function, NK cell non-specific function, and culture filtrate protein-10 (CFP-10) spot number as the optimally diagnostic model for differentiating ATB from LTBI. The AUC of the model in distinguishing between ATB and LTBI was 0.939 (95% CI, 0.898-0.981). The sensitivity and specificity were 83.67% (95% CI, 70.96%-91.49%) and 90.63% (95% CI, 81.02%-95.63%) with the threshold as 0.57. Our established model showed superior performance to TB-specific antigen (TBAg)/PHA ratio in stratifying TB infection status.ConclusionsLymphocyte non-specific function detection offers an attractive alternative to facilitate TB diagnosis. The three-index diagnostic model was proved to be a potent tool for the identification of different events involved in TB infection, which is helpful for the treatment and management of patients.

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“…Despite great achievement in TB control over past decades, detection of laboratory-confirmed cases had stagnated at around 30% of the notified cases [ 3 ]. As a consequence, delay in diagnosis of pulmonary TB leads to increasing severity, mortality and transmission in the community [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Incidence and risk factors of postoperative complications in patients with tuberculosis-destroyed lung

et al. 2021

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Background The purpose of this study was to determine risk factors of postoperative complications in tuberculosis-destroyed lung (TDL) patients. Methods We retrospectively analyzed the data from all consecutive TDL patients undergoing surgical treatment at the Beijing Chest Hospital from January 2001 to September 2019. Results Of 113 TDL cases experiencing surgery, 33 (29.2%) experienced postoperative complications. The patients with low BMI were more likely to have postoperative complications compared to those with normal BMI, whereas a significant lower rate of postoperative complications was noted in patients with BMI ≥ 25 kg/m2. In addition, significant increased risk was observed in patients with smoking history. We found that the patients with underlying infection, including aspergillus and nontuberculous mycobacteria (NTM), had significantly higher odds of having postoperative complications compared with those without underlying infection. The anaemia was another important independent factor associated with postoperative complication. Patients with blood transfusion above 1000 mL had a strongly increased frequency of postoperative complications than patients with blood transfusion below 1000 mL. Conclusion In conclusion, our data demonstrate that approximate one third of TDL patients experience postoperative complications in our cohort. Patients with low BMI, anaemia, tobacco smoking, and coinfected aspergillus or NTM are at markedly higher risk to experience postoperative complications after pneumonectomy.

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Delay in the diagnosis of pulmonary tuberculosis in The Gambia, West Africa: A cross-sectional study

Cited by 27 publications

References 23 publications

Impact of Protracted Displacement on Delay in the Diagnosis Associated with Treatment Outcomes: A Cross-sectional Study in Internally Displaced Tuberculosis Patients of Pakistan

Impact of Protracted Displacement on Delay in the Diagnosis Associated with Treatment Outcomes: A Cross-sectional Study in Internally Displaced Tuberculosis Patients of Pakistan

Lymphocyte Non-Specific Function Detection Facilitating the Stratification of Mycobacterium tuberculosis Infection

Incidence and risk factors of postoperative complications in patients with tuberculosis-destroyed lung

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