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Free Content Efficiency of a third serial sputum smear examination in the diagnosis of tuberculosis in Moldova and Uganda

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SETTING: Twenty-four and 30 tuberculosis (TB) microscopy laboratories in Moldova and Uganda, respectively.

OBJECTIVE: To estimate the workload required to identify one additional case of TB with a third serial sputum smear examination.

METHODS: Retrospective laboratory register study to determine the prevalence and the incremental yield of TB cases from a third serial sputum smear examination among suspects in Moldova and Uganda, with the reciprocal of the product of these two fractions providing the number of examinations required to identify one additional TB case.

RESULTS: In Moldova, 9% (1141/12525) and in Uganda 20% (7280/36054) of suspects met the TB case definition with at least one positive sputum smear. The incremental yield from the third examination was 4% in Moldova and 3% in Uganda. To detect one additional TB case on a third smear, 273 examinations (95%CI 200–389) in Moldova and 175 (95%CI 153–222) in Uganda were thus required. This corresponded to an average of 11 days (8–16) and 7 days (6–9), respectively, to diagnose one additional case of TB.

CONCLUSION: In both countries, the third serial sputum smear examination was inefficient in diagnosing sputum smear-positive TB.
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Keywords: case finding; incremental yield; microscopy; tuberculosis; workload

Document Type: Regular Paper

Affiliations: 1: Case Western Reserve University, Cleveland, Ohio, USA 2: Tuberculosis/AIDS Project Coordination Unit, Chisinau, Republic of Moldova 3: International Union Against Tuberculosis and Lung Disease, Paris, France

Publication date: June 1, 2007

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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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