Prediction Models for Prevalent Pulmonary Tuberculosis in Adults

Van Wyk, S.S., Lin, H.H. and Claassens, M.M., 2017. A systematic review of prediction models for prevalent pulmonary tuberculosis in adults. The International Journal of Tuberculosis and Lung Disease, 21(4), pp.405-411.

  • Many presumptive TB cases are not identified promptly, leading to diagnostic and treatment delays.
  • Studies focused on developing models using clinical predictors such as history, physical examination, and chest radiography (CXR) to estimate PTB probability; more advanced imaging technologies were excluded due to lack of availability in high TB burden settings.
  • Exclusion criteria for studies involved settings like inpatients, specific populations (e.g., TB contacts, pregnant women, drug users), to reduce heterogeneity.
  • Only six studies met these criteria, developing and validating models to improve PTB detection using additional factors like CD4 count, BMI, and duration on antiretroviral therapy (ART).
  • Addition of the tuberculin skin test (TST) to the WHO symptom screen significantly improved sensitivity for detecting PTB.
  • Development of clinical scores using various predictors to facilitate screening in routine and low-resource settings.
  • Models showed potential for improving diagnostic accuracy by incorporating additional information to WHO recommendations.
  • Highlighted the need for a low-cost, easily applicable TB risk score to enhance screening accuracy and feasibility in high TB burden, low-resource settings.
  • Current reliance on the WHO symptom screen due to the absence of better alternatives.

    •  

    Comments

    Post a Comment

    Popular posts from this blog

    Nutritional status in patients with TB and DM

    Patel, D.G., Baral, T., Kurian, S.J., Malakapogu, P., Saravu, K. and Miraj, S.S., 2024. Nutritional status in patients with tuberculosis and diabetes mellitus: A comparative observational study.  Journal of Clinical Tuberculosis and Other Mycobacterial Diseases ,  35 , p.100428. Cardiovascular disease prevalence was highest in the DM group, followed by the TB-DM group. Anaemia was more prevalent in the TB-DM group. Smoking and alcohol use were most common in the TB group, followed by the TB-DM group. See also: TB and kidney function impairment In the TB-DM group, HbA1c levels indicated poor diabetic control (10.47%), higher than in the DM group (8.17%). FBS was also above normal in the TB-DM group, followed by the DM group. Although there were no significant differences in nutritional parameters like albumin, globulin, and total proteins, vitamin B12 levels were highest in the TB-DM group. Notably, 95.83% of patients in the TB-DM group had HbA1c > 6.5, with similarly high FBS and RB
    Read more

    Scientific advances and the end of tuberculosis

    Reid, M., Agbassi, Y.J.P., Arinaminpathy, N., Bercasio, A., Bhargava, A., Bhargava, M., Bloom, A., Cattamanchi, A., Chaisson, R., Chin, D. and Churchyard, G., 2023. Scientific advances and the end of tuberculosis: a report from the Lancet Commission on Tuberculosis.  The Lancet ,  402 (10411), pp.1473-1498. Progress toward ending tuberculosis varies greatly across countries, with some achieving substantial improvements and others making minimal progress. Key challenges include frail health systems, underinvestment, and reliance on one-size-fits-all approaches. Insufficient case finding and diagnosis remain the most significant issues in high-burden countries, where only 38% of all tuberculosis cases were tested with WHO-recommended rapid molecular diagnostics in 2021. Two-thirds of tuberculosis deaths occurred in just eight countries, with over half of these in India, Indonesia, and Nigeria. Despite these challenges, some sub-Saharan African countries have seen improvements in tubercul
    Read more

    Impact of diabetes on tuberculosis and MDRTB susceptibility

    There is a significant association between diabetes mellitus (DM) and multidrug-resistant tuberculosis (MDR-TB). TB patients without DM have a lower risk of developing MDR-TB compared to those with DM. Factors contributing to MDR-TB emergence in TB patients with DM include: Impaired immune function Altered microbial genomics Uncontrolled glucose levels, increasing susceptibility to MDR-TB Compromised phagocytic activity and reduced chemotactic response Increased oxidative species and microbe proliferation Altered drug disposition Higher likelihood of non-adherence to treatment TB patients with DM also experience higher treatment failure rates compared to those without DM. Most information on these associations is based on self-reported data or patient health records, which may introduce assessment errors Rehman Au, Khattak M, Mushtaq U, Latif M, Ahmad I, Rasool MF, Shakeel S, Hayat K, Hussain R, Alhazmi GA, Alshomrani AO, Alalawi MI, Alghamdi S, Imam MT, Almarzoky Abuhussain SS, Khayya
    Read more