Clinical and radiographic predictors in diagnosing sputum smear-negative pulmonary tuberculosis in HIV-negative patients: a cross-sectional study in China / 中华医学杂志(英文版)
Chinese Medical Journal
; (24): 3662-3667, 2013.
Artigo
em Inglês
| WPRIM (Pacífico Ocidental)
| ID: wpr-236193
Biblioteca responsável:
WPRO
ABSTRACT
<p><b>BACKGROUND</b>In county-level tuberculosis (TB) dispensaries in China, the accurate diagnosis of sputum smear-negative pulmonary tuberculosis (SNPT) needs to be improved by developing and validating clinical and radiographic predictors.</p><p><b>METHODS</b>The study was conducted simultaneously in three counties per province in Chongqing Municipality and Liaoning Province in China between May 2005 and May 2006. A total of 432 new SNPT patients who are HIV-negative and more than 15 years old diagnosed by expert panels in county-level TB dispensaries were recruited. Their sputum samples were collected for culture before anti-TB treatment, and the treatment outcomes (changes of X-rays) were followed up at the end of the 6th month.</p><p><b>RESULTS</b>Of the 432 SNPT patients, sputum culture positive (9.7%) or culture negative with good changes of X-rays at the end of the 6th month (73.6%) was validated as SNPT. Four predictive variables were associated with validated SNPT in the multivariate logistic regression model age ≤55 years old (odds ratio (OR) 5.66; 95% CI 2.69-11.91), >60 days of cough (OR 3.73; 95% CI 1.10-12.65), ≥10% of pulmonary consolidation in the lungs (OR 5.40; 95% CI 2.90-10.06), and pulmonary consolidation in the upper lobe anterior segment (OR 3.00; 95% CI 1.57-5.72). The area under the receiver operating characteristic curve of the model was 0.77 (95% CI 0.71-0.83).</p><p><b>CONCLUSION</b>Four predictors of clinical and radiological characteristics that had a good diagnostic performance of SNPT deserve to be recommended as index indicators of SNPT diagnosis in county-level TB dispensaries in China.</p>
Texto completo:
Disponível
Contexto em Saúde:
ODS3 - Saúde e Bem-Estar
/
Doenças Negligenciadas
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ODS3 - Meta 3.4 Reduzir as mortes prematuras devido doenças não transmissíveis
Problema de saúde:
Meta 3.3: Acabar com as doenças tropicais negligenciadas e combater as doenças transmissíveis
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Doenças Negligenciadas
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Tuberculose
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Outras Doenças Respiratórias
Base de dados:
WPRIM (Pacífico Ocidental)
Assunto principal:
Escarro
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Tuberculose Pulmonar
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Modelos Logísticos
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China
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Estudos Transversais
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Soronegatividade para HIV
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Diagnóstico
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Microbiologia
Tipo de estudo:
Estudo diagnóstico
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Estudo observacional
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Estudo de prevalência
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Estudo prognóstico
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Fatores de risco
Limite:
Adulto
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Feminino
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Humanos
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Masculino
País/Região como assunto:
Ásia
Idioma:
Inglês
Revista:
Chinese Medical Journal
Ano de publicação:
2013
Tipo de documento:
Artigo