Free Content Quality of induced sputum using a human-powered nebuliser in a mobile human immunodeficiency virus testing service in South Africa

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Abstract:

OBJECTIVES: To investigate the quality of induced sputum samples using a human-powered (HPN) and an electric-powered nebuliser (EPN).

METHODS: For each participant two sputum samples were induced using the HPN and the EPN. The sequence of the two nebulisers was allocated at random. The proportion of good quality sputum according to different assessment criteria was compared using an exact McNemar test. The difference in time to expectoration was compared using the Wilcoxon matched-pairs signed-rank test.

RESULTS: A total of 123 individuals were eligible for the study. Nine individuals refused to participate and five were unable to produce a sputum sample. The proportion of good quality sputum was higher among sputum samples induced by the HPN compared to those obtained using the EPN. The median time to produce a sputum sample was 2.2 min (IQR 1.13–4.1) for the HPN and 2.5 min (IQR 1.4–4.1) for the EPN.

CONCLUSION: The HPN induced good quality sputum within 3 min. The device operates without electricity and is suitable not only for remote clinics with unreliable electricity, but also for mobile services and community-based intensified tuberculosis (TB) case finding. Further research needs to investigate the yield of TB in sputum samples induced by the HPN.

Keywords: South Africa; diagnosis; induced sputum; resource-limited; tuberculosis

Document Type: Regular Paper

DOI: http://dx.doi.org/10.5588/ijtld.10.0684

Affiliations: 1: The Desmond Tutu HIV Centre, Institute for Infectious Disease and Molecular Medicine, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa; Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK 2: Department of Biomedical Engineering, Marquette University, Milwaukee, Wisconsin, USA 3: The Desmond Tutu HIV Centre, Institute for Infectious Disease and Molecular Medicine, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa 4: Department of Biomedical Engineering, Northwestern University, Evanston, Illinois, USA 5: Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK

Publication date: August 1, 2011

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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