OBJECTIVE The HIV epidemic has increased the proportion of patients with smear-negative and extrapulmonary tuberculosis (TB) diagnoses, with related higher rates of poor TB treatment outcomes. Unlike in smear-positive pulmonary TB, no interim markers of TB treatment progress are systematically used to identify individuals most at risk of mortality. The objective of this study was to assess the ...

Xpert MTB/RIF-generated cycle-threshold (C(T)) values have poor clinical utility as a rule-in test for smear positivity (cut-point ≤20.2; sensitivity 32.3%, specificity 97.1%) but moderately good rule-out value (cut-point >31.8; negative predictive value 80.0%). Thus, 20% of individuals with C(T) values >31.8 were erroneously ruled out as smear-negative. This group had a significantly lower spu...

The Cepheid Xpert MTB/RIF research-use-only (RUO) assay and a laboratory-developed test (LDT) targeting IS6110 were evaluated and compared to mycobacterial culture as the gold standard. The performance characteristics of both molecular assays were determined by using 112 specimens from 90 patients, including 89 pulmonary specimens and 23 extrapulmonary specimens. Of the specimens tested, 37 (33...

The proportion of patients with recurrent tuberculosis (TB) is reported to be increased in TB patients with human immunodeficiency virus (HIV) infection after they have completed treatment. Despite rising HIV seroprevalence amongst TB patients in Malawi, notifications of patients with relapse smear-positive pulmonary TB (PTB) and recurrent smear-negative TB have remained stable during the past ...

OBJECTIVE There are no rules to predict the time to infectivity negative conversion based on sputum smear conversion or culture conversion during chemotherapy in smear-positive tuberculosis patients. We aimed to develop and validate rules of sputum smear grades and cavitations in the lungs due to tuberculosis. METHODS This study was a retrospective cohort study that consisted of development (...

background and objectives: sputum smear staining for acid-fast bacilli is initial approach to the diagnosis of pulmonary tuberculosis (ptb) but more than 50% of cases are sputum smear-negative. this study was aimed to investigate the diagnostic value of fiberoptic bronchoscopy (fob) guided bronchoalveolar lavage (bal) in patients suspected to have tuberculosis. methods: this prospective cross-s...

introduction: the aim of this in vitro study was to evaluate the effect of an experimental irrigation solution, containing two different concentrations of papain, tween 80, 2% chlorhexidine and edta, on removal of the smear layer. methods and materials: thirty-six single-rooted teeth were divided into two experimental groups ( n =12) and two positive and negative control groups of six. the cana...

BACKGROUND The Xpert™ MTB/RIF (XP) has a higher sensitivity than sputum smear microscopy (70% versus 35%) for TB diagnosis and has been endorsed by the WHO for TB high burden countries to increase case finding among HIV co-infected presumptive TB patients. Its impact on the diagnosis of smear-negative TB in a routine care setting is unclear. We determined the change in diagnosis, treatment and ...

BACKGROUND The existing World Health Organization diagnostic algorithms for smear-negative TB perform poorly in HIV-infected individuals. New TB diagnostics such as urine TB lipoarabinomannan (LAM) could improve the accuracy and reduce delays in TB diagnosis in HIV-infected smear-negative presumptive TB. We sought to determine predictors for MTB culture-positivity among these patients. METHOD...