An Early Morning Sputum Sample Is Necessary for the Diagnosis of Pulmonary Tuberculosis, Even with More Sensitive Techniques: A Prospective Cohort Study among Adolescent TB-Suspects in Uganda

The World Health Organization (WHO) recommends collection of two sputum samples for tuberculosis (TB) diagnosis, with at least one being an early morning (EM) using smear microscopy. It remains unclear whether this is necessary even when sputum culture is employed. Here, we determined the diagnostic...

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Main Authors:	Willy Ssengooba, David P. Kateete, Anne Wajja, Eric Bugumirwa, Gerald Mboowa, Carolyn Namaganda, Germine Nakayita, Maria Nassolo, Francis Mumbowa, Benon B. Asiimwe, James Waako, Suzanne Verver, Philippa Musoke, Harriet Mayanja-Kizza, Moses L. Joloba
Format:	Article
Language:	English
Published:	Hindawi Limited 2012-01-01
Series:	Tuberculosis Research and Treatment
Online Access:	http://dx.doi.org/10.1155/2012/970203

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spelling	doaj-56fda5e5e64a4f13b360c58ab52885df2020-11-24T23:13:28ZengHindawi LimitedTuberculosis Research and Treatment2090-150X2090-15182012-01-01201210.1155/2012/970203970203An Early Morning Sputum Sample Is Necessary for the Diagnosis of Pulmonary Tuberculosis, Even with More Sensitive Techniques: A Prospective Cohort Study among Adolescent TB-Suspects in UgandaWilly Ssengooba0David P. Kateete1Anne Wajja2Eric Bugumirwa3Gerald Mboowa4Carolyn Namaganda5Germine Nakayita6Maria Nassolo7Francis Mumbowa8Benon B. Asiimwe9James Waako10Suzanne Verver11Philippa Musoke12Harriet Mayanja-Kizza13Moses L. Joloba14Department of Medical Microbiology, School of Biomedical Sciences, Makerere University College of Health Sciences, Kampala, UgandaDepartment of Medical Microbiology, School of Biomedical Sciences, Makerere University College of Health Sciences, Kampala, UgandaInfectious Diseases Institute, Makerere University College of Health Sciences, Kampala, UgandaDepartment of Medical Microbiology, School of Biomedical Sciences, Makerere University College of Health Sciences, Kampala, UgandaDepartment of Medical Microbiology, School of Biomedical Sciences, Makerere University College of Health Sciences, Kampala, UgandaDepartment of Medical Microbiology, School of Biomedical Sciences, Makerere University College of Health Sciences, Kampala, UgandaDepartment of Medical Microbiology, School of Biomedical Sciences, Makerere University College of Health Sciences, Kampala, UgandaDepartment of Medical Microbiology, School of Biomedical Sciences, Makerere University College of Health Sciences, Kampala, UgandaDepartment of Medical Microbiology, School of Biomedical Sciences, Makerere University College of Health Sciences, Kampala, UgandaDepartment of Medical Microbiology, School of Biomedical Sciences, Makerere University College of Health Sciences, Kampala, UgandaInfectious Diseases Institute, Makerere University College of Health Sciences, Kampala, UgandaKNCV Tuberculosis Foundation, The Hague and CINIMA, Academic Medical Centre, Parkstraat 17, 2514 JD The Hague, The NetherlandsInfectious Diseases Institute, Makerere University College of Health Sciences, Kampala, UgandaInfectious Diseases Institute, Makerere University College of Health Sciences, Kampala, UgandaDepartment of Medical Microbiology, School of Biomedical Sciences, Makerere University College of Health Sciences, Kampala, UgandaThe World Health Organization (WHO) recommends collection of two sputum samples for tuberculosis (TB) diagnosis, with at least one being an early morning (EM) using smear microscopy. It remains unclear whether this is necessary even when sputum culture is employed. Here, we determined the diagnostic yield from spot and the incremental yield from the EM sputum sample cultures among TB-suspected adolescents from rural Uganda. Sputum samples (both spot and early-morning) from 1862 adolescents were cultured by the Lowenstein-Jensen (LJ) and Mycobacterium Growth Indicator Tube (MGIT) methods. For spot samples, the diagnostic yields for TB were 19.0% and 57.1% with LJ and MGIT, respectively, whereas the incremental yields (not totals) of the early-morning sample were 9.5% and 42.9% (P<0.001) with LJ and MGIT, respectively. Among TB-suspected adolescents in rural Uganda, the EM sputum culture has a high incremental diagnostic yield. Therefore, EM sputum in addition to spot sample culture is necessary for improved TB case detection.http://dx.doi.org/10.1155/2012/970203
collection	DOAJ
language	English
format	Article
sources	DOAJ
author	Willy Ssengooba David P. Kateete Anne Wajja Eric Bugumirwa Gerald Mboowa Carolyn Namaganda Germine Nakayita Maria Nassolo Francis Mumbowa Benon B. Asiimwe James Waako Suzanne Verver Philippa Musoke Harriet Mayanja-Kizza Moses L. Joloba
spellingShingle	Willy Ssengooba David P. Kateete Anne Wajja Eric Bugumirwa Gerald Mboowa Carolyn Namaganda Germine Nakayita Maria Nassolo Francis Mumbowa Benon B. Asiimwe James Waako Suzanne Verver Philippa Musoke Harriet Mayanja-Kizza Moses L. Joloba An Early Morning Sputum Sample Is Necessary for the Diagnosis of Pulmonary Tuberculosis, Even with More Sensitive Techniques: A Prospective Cohort Study among Adolescent TB-Suspects in Uganda Tuberculosis Research and Treatment
author_facet	Willy Ssengooba David P. Kateete Anne Wajja Eric Bugumirwa Gerald Mboowa Carolyn Namaganda Germine Nakayita Maria Nassolo Francis Mumbowa Benon B. Asiimwe James Waako Suzanne Verver Philippa Musoke Harriet Mayanja-Kizza Moses L. Joloba
author_sort	Willy Ssengooba
title	An Early Morning Sputum Sample Is Necessary for the Diagnosis of Pulmonary Tuberculosis, Even with More Sensitive Techniques: A Prospective Cohort Study among Adolescent TB-Suspects in Uganda
title_short	An Early Morning Sputum Sample Is Necessary for the Diagnosis of Pulmonary Tuberculosis, Even with More Sensitive Techniques: A Prospective Cohort Study among Adolescent TB-Suspects in Uganda
title_full	An Early Morning Sputum Sample Is Necessary for the Diagnosis of Pulmonary Tuberculosis, Even with More Sensitive Techniques: A Prospective Cohort Study among Adolescent TB-Suspects in Uganda
title_fullStr	An Early Morning Sputum Sample Is Necessary for the Diagnosis of Pulmonary Tuberculosis, Even with More Sensitive Techniques: A Prospective Cohort Study among Adolescent TB-Suspects in Uganda
title_full_unstemmed	An Early Morning Sputum Sample Is Necessary for the Diagnosis of Pulmonary Tuberculosis, Even with More Sensitive Techniques: A Prospective Cohort Study among Adolescent TB-Suspects in Uganda
title_sort	early morning sputum sample is necessary for the diagnosis of pulmonary tuberculosis, even with more sensitive techniques: a prospective cohort study among adolescent tb-suspects in uganda
publisher	Hindawi Limited
series	Tuberculosis Research and Treatment
issn	2090-150X 2090-1518
publishDate	2012-01-01
description	The World Health Organization (WHO) recommends collection of two sputum samples for tuberculosis (TB) diagnosis, with at least one being an early morning (EM) using smear microscopy. It remains unclear whether this is necessary even when sputum culture is employed. Here, we determined the diagnostic yield from spot and the incremental yield from the EM sputum sample cultures among TB-suspected adolescents from rural Uganda. Sputum samples (both spot and early-morning) from 1862 adolescents were cultured by the Lowenstein-Jensen (LJ) and Mycobacterium Growth Indicator Tube (MGIT) methods. For spot samples, the diagnostic yields for TB were 19.0% and 57.1% with LJ and MGIT, respectively, whereas the incremental yields (not totals) of the early-morning sample were 9.5% and 42.9% (P<0.001) with LJ and MGIT, respectively. Among TB-suspected adolescents in rural Uganda, the EM sputum culture has a high incremental diagnostic yield. Therefore, EM sputum in addition to spot sample culture is necessary for improved TB case detection.
url	http://dx.doi.org/10.1155/2012/970203
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An Early Morning Sputum Sample Is Necessary for the Diagnosis of Pulmonary Tuberculosis, Even with More Sensitive Techniques: A Prospective Cohort Study among Adolescent TB-Suspects in Uganda

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