Spot sputum samples are at least as good as early morning samples for identifying Mycobacterium tuberculosis

Murphy, Michael E.; Phillips, Patrick P. J.; Mendel, Carl M.; Bongard, Emily; Bateson, Anna; Hunt, Robert D.; Murthy, Saraswathi; Singh, Kasha; Brown, Michael J.; Crook, Angela M.; Nunn, Andrew; Meredith, Sarah; Lipman, Marc; McHugh, Timothy D.; Gillespie, Stephen H.

doi:10.1186/s12916-017-0947-9

Cited by 13 publications

(8 citation statements)

References 18 publications

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“…Another study conducted in Uganda in 2017 by Michael E concluded that spot sample is as good as early morning sputum samples for TB diagnosis. This study also concluded that there is no yielding difference between spot and morning collection methods for diagnosis of TB using Gene Xpert MTB/RIF Assay (Michael et al, 2017).…”

Section: Discussionmentioning

confidence: 65%

Trend of Mortality by Water Related Intestinal infectious Diseases: A Study of National Capital Territory of Delhi, (2001 to 2011)

Molla

2019

JMRH

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Background: Tuberculosis is a global health problem and leading cause of mortality and morbidity in the world. Correct diagnosis of tuberculosis is the main challenge for control of tuberculosis. World health organization has prioritized improving diagnostic guidelines and tests for TB diagnosis. Priority has been given for development of new Tuberculosis diagnostic methods. But diagnosis of Tuberculosis highly affected by quality specimen collected which has been given less attention. The aim of this is to assess Yielding accuracy of morning and spot sputum samples for diagnosis Mycobacterium tuberculosis using Gene Xpert Mycobacterium Tuberculosis (MTB)/Rifampicin Resistance (RIF).Methodology: Cross sectional study was conducted and convenient sampling technique used to select participants. Checklists used to collect the data from April 1 to May 30, 2018 G.C. A total of two hundred twenty two (222) sputum samples from 111 suspected tuberculosis patients were analyzed using Gene Xpert MTB/RIF Assay. SPSS version 20 was used for statistical analysis. Results: From 111 TB suspected patients, 55.9% were male and the rest of 44.1% was female. In terms of sample quality, 81.1% morning sputum samples and 79.3% spot sputum samples were had good sample quality. The outcomes of the research show an increase in odds value in sputum quality and sputum consistency for TB diagnosis. But, the relation is not significant associationwith TB positivity.Conclusion: Based on the results of this study, the diagnosis of TB using spot sputum samples as well as using morning sputum samples is almost similar for detection of MTB by Gene Xpert MTB/RIF Assay. Physical Quality of sputum sample or consistency is not association with TB positivity using Gene Xpert MTB/RIF Assay. Results: From 111 TB suspected patients, 55.9% were male and the rest of 44.1% was female. In terms of sample quality, 81.1% morning sputum samples and 79.3% spot sputum samples were had good sample quality. The outcomes of the research shows an increase in odds value in sputum quality and sputum consistency for TB diagnosis. But, the relation is not significant association with TB positivity. Conclusion: Based on the results of this study, the diagnosis of TB using spot sputum samples as well as using morning sputum samples is almost similar for the detection of MTB by Gene Xpert MTB/RIF Assay. Physical Quality of sputum sample or consistency is not associated with TB positivity using Gene Xpert MTB/RIF Assay.

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Section: Discussionmentioning

confidence: 65%

Trend of Mortality by Water Related Intestinal infectious Diseases: A Study of National Capital Territory of Delhi, (2001 to 2011)

Molla

2019

JMRH

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“…As mentioned by laboratory professionals, the current sputum collection method (spotspot) has been leading them to Health system diagnosis delay. The different studies' findings, including systematic review and meta-analysis, were against this finding [18][19][20]. Early morning sputum samples (EMS) are generally considered to yield a greater number of positive results than spot samples and to have higher sensitivity and specificity for culture, yet the published data to support this assumption is scarce.…”

Section: Discussionmentioning

confidence: 99%

Why health system diagnosis delay among tuberculosis patients in Illubabor, Oromia region, South West Ethiopia? A qualitative study

et al. 2022

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Background The main target of tuberculosis control and prevention is to detect incident cases as quickly as possible and also to prevent the occurrence of disease. It is also the responsibility of the health facility to screen the contacts, identifying children for prophylactic therapy. However, the target is difficult to meet due to issues within health facilities that cause health system diagnostic delays. Despite this, there is no information explored why health system diagnostic delays among tuberculosis patients. Method A qualitative study was conducted by using different data collection methods and sources. Seventeen DOT providers, five laboratory professionals, six program managers, and seven Tuberculosis patients were interviewed. In addition, 22 governmental health facilities were observed for the availability of resources. Data obtained from the in-depth interviews was transcribed, coded, categorized, and thematized manually. Result Health system Diagnosis delays reasons were related with sample collection procedures, poor competency of health professionals, in addition to absences or scarcity of health professionals, medical products, and basic infrastructure. We found 18 health facilities without skilled personnel in the OPD, 7 health facilities with a broken microscope, and almost all health facilities without a separate room for sputum examination. Furthermore, 12 (54.5%) and 14 (63.6%) health facilities lacked access to water and electric power, respectively. Conclusion Many reasons for TB diagnosis delays have been identified in the study area. Poor competence of health workers and scarcity of resources were identified. Depending on the finding, we suggest strengthening the health workers’ training. Concrete strategies need to be designed to retain professionals. Training on human resource planning and budget preparation is needed for front-line managers. Managers have to work on the maintenance of diagnostic tools and facilitate transportation. The rural health facilities need to use another alternative power source.

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“…showed that spot sample are similar with early morning sputum sample for diagnosis of Pulmonary TB. [18] There is delay in health-seeking behaviors for various diseases and which is also true for pulmonary TB. TB patients at times have to make multiple visits to health facilities before they were diagnosed and get treated.…”

Section: Discussionmentioning

confidence: 99%

Concordance of two sputum smear microscopy for diagnosis of presumptive pulmonary tuberculosis in a tertiary care hospital

Pala

Lynrah

2017

Int J Community Med Public Health

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Background: Under revised National tuberculosis control program two sputum samples are to be collected for diagnosis of presumptive pulmonary tuberculosis case. The objective of this study is to find the concordance of both sputum smear microscopy samples at a tertiary care hospital. Methods: Hospital based record was collected from designated microscopy center laboratory register. The data collected were from January 2015 to November 2016. Results: A total of 2117 paired of sputum sample were collected for the year 2015-16 in one of the DMC of a tertiary care hospital. A total of 183 patient (at least one sputum sample) were positive (8.64%) and 1934 were both negative. Among the positive sample concordance for both spot and morning samples were 89% (163/183) and discordance where spot sample positive and morning sample negative was 4.91% (9/183) and where spot sample negative and morning sample positive was 6.01% (11/183). Overall discordance between spot and morning samples were only 0.94% (20/2117). Conclusions: There is a good concordance of two sputum samples. Discordance of two sputum samples were <1% in a tertiary care hospital. One sample may be sufficient for operational purpose for diagnosis of pulmonary Tb. But to have a robust recommendation a RCT will be required to see the extent of discordance by ruling out bias in sputum smear examination.

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Spot sputum samples are at least as good as early morning samples for identifying Mycobacterium tuberculosis

Cited by 13 publications

References 18 publications

Trend of Mortality by Water Related Intestinal infectious Diseases: A Study of National Capital Territory of Delhi, (2001 to 2011)

Trend of Mortality by Water Related Intestinal infectious Diseases: A Study of National Capital Territory of Delhi, (2001 to 2011)

Why health system diagnosis delay among tuberculosis patients in Illubabor, Oromia region, South West Ethiopia? A qualitative study

Concordance of two sputum smear microscopy for diagnosis of presumptive pulmonary tuberculosis in a tertiary care hospital

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