Definitive laboratory diagnosis and confirmation of sputum smear-negative pulmonary tuberculosis (SNPTB) poses a major challenge in the management and control of active pulmonary tuberculosis (TB) in clinical practice. It is estimated that there are 1.22 cases of SNPTB and extra-pulmonary TB for every case of smear-positive TB in developing countries[1]. In resource-poor settings, smear negativ...

Information regarding the utility of adjunct diagnostic tests in combination with Xpert MTB/RIF (Cepheid, Sunnyvale, CA, USA) is limited. We hypothesised adjunct tests could enhance accuracy and/or reduce the cost of tuberculosis (TB) diagnosis prior to MTB/RIF testing, and rule-in or rule-out TB in MTB/RIF-negative individuals. We assessed the accuracy and/or laboratory-associated cost of diag...

When Magdalena was 15 years old she was diagnosed with smear-positive pulmonary tuberculosis (TB). She lived with her mother, a stepfather and 13 siblings in a very humble dwelling in an Andean country. Her stepfather would often beat her because she was unable to perform her assigned domestic chores. As a result, she would flee and abandon her treatment. She was prescribed several regimens whi...

BACKGROUND The grading of radiological severity in clinical trials in tuberculosis (TB) remains unstandardised. The aim of this study was to generate and validate a numerical score for grading chest x-ray (CXR) severity and predicting response to treatment in adults with smear-positive pulmonary TB. METHODS At a TB clinic in Papua, Indonesia, serial CXRs were performed at diagnosis, 2 and 6 m...

STUDY OBJECTIVES Identification of acid-fast bacilli (AFB) in the sputum smear at the completion of tuberculosis therapy is in some settings considered evidence of treatment failure. However, some patients with pulmonary tuberculosis (TB) will have positive smear results with negative sputum culture results at the end of therapy. The objectives of this study were to estimate the prevalence of p...

BACKGROUND Flexible bronchoscopy with bronchial washing is a useful procedure for diagnosis of pulmonary tuberculosis (TB), when a patient cannot produce sputum spontaneously or when sputum smears are negative. However, the benefit of gaining serial bronchial washing specimens for diagnosis of TB has not yet been studied. Therefore, we conducted a retrospective study to determine the diagnostic...

BACKGROUND Clinicians need to decide whether to begin empiric therapy for patients who are suspected of having tuberculosis (TB) but have negative sputum smear results. Culture results may take weeks, and delaying treatment may allow further transmission of disease. STUDY OBJECTIVE To identify the clinical, demographic, and radiographic characteristics that identify smear-negative patients wh...

OBJECTIVE To assess the diagnostic yield of fibreoptic bronchoscopy and bronchoalveolar lavage (BAL) compared to gastric aspiration (GA) in children with probable pulmonary tuberculosis (TB). METHODS Children with probable pulmonary TB were subjected to bronchoscopy, BAL and gastric aspiration. The samples were examined for acid fast bacilli (AFB) on smear. RESULTS A total of 52 children un...

BACKGROUND With Fluorotype MTB (FT MTB, HAIN Lifesciences, Germany) a new semi-automated assay for detection of M. tuberculosis complex (MTBC) in clinical specimens has been introduced. In a prospective study, we evaluated the diagnostic performance of FT MTB in a routine diagnostic setting in a low-incidence country. METHODS A total of 1039 respiratory specimens received for routine mycobact...

SETTING Five districts in Sri Lanka. OBJECTIVES To determine: 1) the proportion of sputum smear-positive pulmonary tuberculosis (PTB) cases who failed to smear convert at 2 months, 2) their management, and 3) whether baseline characteristics and final treatment outcomes were different from those who did smear convert. DESIGN Cross-sectional retrospective review of medical files, tuberculosi...