TB contacts in family and high positive smear: Is there a need of sputum culture at the earliest?
Journal: International Journal of Medical Science Research and Practice (Vol.1, No. 3)Publication Date: 2014-11-30
Authors : Author Priya Y Kulkarni Co-Author Atul D Kulkarni; Sulabha V Akarte;
Page : 95-99
Keywords : Anti tubercular treatment (ATT); DOTS; High Positive Smear (HPS); MDR-TB; RNTCP; Tuberculosis;
- TB contacts in family and high positive smear: Is there a need of sputum culture at the earliest?
- Yield of AFB by direct sputum smear examination with bronchial washings and post bronchoscopy sputum smear examination
- Same day sputum smear microscopy with an economical destaining step for the diagnosis of pulmonary tuberculosis
- Enhancement of yield of acid fast bacilli in smear negative sputum microscopy with sodium hypochlorite decontamination sedimentation technique
- Trend of sputum smear positivity among presumptive tuberculosis cases visiting respiratory disease centre of Western Maharashtra, India
Abstract
Aim To assess the role of TB contacts at various places in severity of PTB. Background Tremendous progress has been made in combating TB over the past ten years. But, dramatic changes in TB epidemiology are challenging TB control activities. Material Methods An observational study at DOTS centers in E ward of Mumbai Municipal Corporation was carried out during 1st January 2004 to 30th June 2004. A Pre-tested structured interview schedules were fulfilled by interviewing new smear positive pulmonary tuberculosis patients registered during study period. Data regarding sputum smear examination report at the beginning & at the end of intensive phase were collected from respective DOTS centre. Results 156 patients were interviewed with 67.3% males & 32.7% females. 24.2% were illiterate, 43.3% were unemployed, 52% belonged to socio-economic class IV & V, 53.8% were migrants.52.6% had history of known TB contact. High positive sputum smear was associated with history of known TB contact in family (p= 0.03, OR= 1.773, 95%CI= 1.102- 3.094). Patients with high sputum smear positivity were more likely to show sputum smear non-conversion at the end of intensive phase (OR= 2.347, 95% CI= 0.953- 5.782). Conclusion Contacts in family play important role in causation of severe TB disease & consequently sputum non-conversion which is a risk factor for MDR-TB. Physicians or facilities can take decision about investigations like sputum culture and sensitivity at the earliest for such patients.
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