The inconsistent definitions used for tuberculosis in the medical literature

Abstract

In order to assess the confusion attendant with current definitions of extrapulmonary tuberculosis, pleural and miliary disease, a set of 37 papers published which analyzed disease states were assessed for how the terms adhered to official definitions of the American Thoracic Society, the World Health Organization, and the Centers for Disease Control. The findings showed uncertainties in the classification of extrapulmonary disease, a frequent inconsistency in the inclusion of pleural disease within pulmonary rather than extrapulmonary disease, and the ambivalent use of the terms pleural and disseminated tuberculosis. Further attention by editors and authors is needed in the use of tuberculosis definitions.

Tuberkulosis diseminata pada kehamilan

“…5 Tuberkulosis dalam kehamilan mempunyai gejala klinis yang serupa dengan TB pada wanita yang tidak hamil dan diagnosis mungkin terlambat ditegakkan karena manifestasi yang tidak khas, tertutup oleh gejala-gejala dalam kehamilan. 6 Sehingga penegakan diagnosa tuberkulosis dalam kehamilan merupakan suatu tantangan tersendiri. Penurunan berat badan pada TB tertutupi dengan berat badan normal karena kehamilan dan keluhan lainnya dihubungkan dengan kehamilan juga.…”

“…Tuberkulosis milier merupakan salah satu faktor penyebab utama kejadian koroiditis TB. 17 6 Sampai saat ini tidak ada konsensus yang mengatakan dengan pasti berapa jumlah vaksin BCG yang diberikan, kapan pemberian vaksin BCG dan interpretasi hasil vaksin BCG pada bayi dengan wanita yang terinfeksi TB. 19 Ikatan batin antara ibu dan anak sangat penting dan pemberian air susu ibu memainkan peranan penting dalam membentuk kekebalan pada bayi pada awal kehidupan.…”

Estimating the impact of tuberculosis anatomical classification on treatment outcomes: A patient and surveillance perspective analysis

“…The definitions of PTB and EPTB are inconsistent in the literature[ 10 ]. Based mainly on the risk of transmission and guided by anatomy, the World Health Organization (WHO) classifies all patients into two categories: PTB (i.e., pulmonary, pulmonary with concomitant extrapulmonary, laryngeal and miliary disease) and EPTB (i.e., disease involving organs other than the lungs)[ 11 ].…”

“…However, other definitions from international societies and national organizations contain an extended anatomical TB classification and, additionally, report a third category labelled disseminated TB (i.e., miliary, two or more non-contiguous extrapulmonary sites or positive blood culture)[ 7 , 12 , 13 ]. This inconsistency in TB anatomical classification has direct implications for both the interpretation of TB epidemiology and program evaluations[ 4 , 5 , 7 , 10 ], and for treatment decisions, with potential impact on treatment outcomes[ 13 , 14 ].…”

“…The variations in EPTB classification constitute a public health problem that is neither widely recognized nor well understood. Although efforts have been made to improve diagnostic methods, EPTB has been considered a neglected disease[ 7 , 10 , 15 ]. We conducted this study with the primary aim of investigating whether an extended anatomical TB definition better identifies a patient’s likelihood of an unfavourable treatment outcome.…”