Journal article

Simple measures are as effective as invasive techniques in the diagnosis of pulmonary tuberculosis in Malawi

DJ Bell, R Dacombe, SM Graham, A Hicks, D Cohen, T Chikaonda, N French, ME Molyneux, EE Zijlstra, SB Squire, SB Gordon

INTERNATIONAL JOURNAL OF TUBERCULOSIS AND LUNG DISEASE | INT UNION AGAINST TUBERCULOSIS LUNG DISEASE (I U A T L D) | Published : 2009

Abstract

SETTING: Detection of smear-positive pulmonary tuberculosis (PTB) cases is vital for tuberculosis (TB) control. Methods to augment sputum collection are available, but their additional benefit is uncertain in resource-limited settings. OBJECTIVE: To compare the diagnostic yields using five methods to obtain sputum from adults diagnosed with smear-negative PTB in Malawi. DESIGN: Self-expectorated sputum was collected under supervision for microscopy and mycobacterial culture in the study laboratory. Confirmed smear-negative patients provided physiotherapy-assisted sputum and induced sputum, followed the next morning by gastric washing and bronchoalveolar lavage (BAL) samples. RESULTS: A total..

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Grants

Awarded by WT Training Fellowship in Clinical Tropical Medicine


Awarded by WT Career Development Fellowship


Funding Acknowledgements

The authors thank S Kara, physiotherapist, for training staff in the techniques of chest physiotherapy and induced sputum; R Cooke, the study team, G Mwafulirwa, R Malamba, N Mthunkama, M Kunkeyani and G Musowa, and the patients and Staff at Queen Elizabeth Central Hospital, Malawi. The study was funded by the Wellcome Trust (WT). D J Bell held a WT Training Fellowship in Clinical Tropical Medicine (no. 066681), S M Graham was a recipient of WT funding (core grant 074124/Z/04/Z), N French held a WT Career Development Fellowship (no. 061230) and S B Gordon held a WT Career Development Fellowship (no. 061231). The Wellcome Trust had no role in the planning of the study or in the data analysis and preparation of the manuscript.