High yield of culture-based diagnosis in a TB-endemic setting

dc.contributor.authorDemers, Anne-Marieen_ZA
dc.contributor.authorVerver, Suzanneen_ZA
dc.contributor.authorBoulle, Andrewen_ZA
dc.contributor.authorWarren, Robinen_ZA
dc.contributor.authorvan Helden, Paulen_ZA
dc.contributor.authorBehr, Marcelen_ZA
dc.contributor.authorCoetzee, Daviden_ZA
dc.date.accessioned2015-11-18T03:58:42Z
dc.date.available2015-11-18T03:58:42Z
dc.date.issued2012en_ZA
dc.description.abstractBACKGROUND: In most of the world, microbiologic diagnosis of tuberculosis (TB) is limited to microscopy. Recent guidelines recommend culture-based diagnosis where feasible. METHODS: In order to evaluate the relative and absolute incremental diagnostic yield of culture-based diagnosis in a high-incidence community in Cape Town, South Africa, subjects evaluated for suspected TB had their samples processed for microscopy and culture over a 21 month period. RESULTS: For 2537 suspect episodes with 2 smears and 2 cultures done, 20.0% (508) had at least one positive smear and 29.9% (760) had at least one positive culture. One culture yielded 1.8 times more cases as 1 smear (relative yield), or an increase of 12.0% (absolute yield). Based on the latter value, the number of cultures needed to diagnose (NND) one extra case of TB was 8, compared to 19 if second specimens were submitted for microscopy. CONCLUSION: In a high-burden setting, the introduction of culture can markedly increase TB diagnosis over microscopy. The concept of number needed to diagnose can help in comparing incremental yield of diagnosis methods. Although new promising diagnostic molecular methods are being implemented, TB culture is still the gold standard.en_ZA
dc.identifier.apacitationDemers, A., Verver, S., Boulle, A., Warren, R., van Helden, P., Behr, M., & Coetzee, D. (2012). High yield of culture-based diagnosis in a TB-endemic setting. <i>BMC Infectious Diseases</i>, http://hdl.handle.net/11427/15077en_ZA
dc.identifier.chicagocitationDemers, Anne-Marie, Suzanne Verver, Andrew Boulle, Robin Warren, Paul van Helden, Marcel Behr, and David Coetzee "High yield of culture-based diagnosis in a TB-endemic setting." <i>BMC Infectious Diseases</i> (2012) http://hdl.handle.net/11427/15077en_ZA
dc.identifier.citationDemers, A. M., Verver, S., Boulle, A., Warren, R., Van Helden, P., Behr, M. A., & Coetzee, D. (2012). High yield of culture-based diagnosis in a TB-endemic setting. BMC infectious diseases, 12(1), 218.en_ZA
dc.identifier.ris TY - Journal Article AU - Demers, Anne-Marie AU - Verver, Suzanne AU - Boulle, Andrew AU - Warren, Robin AU - van Helden, Paul AU - Behr, Marcel AU - Coetzee, David AB - BACKGROUND: In most of the world, microbiologic diagnosis of tuberculosis (TB) is limited to microscopy. Recent guidelines recommend culture-based diagnosis where feasible. METHODS: In order to evaluate the relative and absolute incremental diagnostic yield of culture-based diagnosis in a high-incidence community in Cape Town, South Africa, subjects evaluated for suspected TB had their samples processed for microscopy and culture over a 21 month period. RESULTS: For 2537 suspect episodes with 2 smears and 2 cultures done, 20.0% (508) had at least one positive smear and 29.9% (760) had at least one positive culture. One culture yielded 1.8 times more cases as 1 smear (relative yield), or an increase of 12.0% (absolute yield). Based on the latter value, the number of cultures needed to diagnose (NND) one extra case of TB was 8, compared to 19 if second specimens were submitted for microscopy. CONCLUSION: In a high-burden setting, the introduction of culture can markedly increase TB diagnosis over microscopy. The concept of number needed to diagnose can help in comparing incremental yield of diagnosis methods. Although new promising diagnostic molecular methods are being implemented, TB culture is still the gold standard. DA - 2012 DB - OpenUCT DO - 10.1186/1471-2334-12-218 DP - University of Cape Town J1 - BMC Infectious Diseases LK - https://open.uct.ac.za PB - University of Cape Town PY - 2012 T1 - High yield of culture-based diagnosis in a TB-endemic setting TI - High yield of culture-based diagnosis in a TB-endemic setting UR - http://hdl.handle.net/11427/15077 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/15077
dc.identifier.urihttp://dx.doi.org/10.1186/1471-2334-12-218
dc.identifier.vancouvercitationDemers A, Verver S, Boulle A, Warren R, van Helden P, Behr M, et al. High yield of culture-based diagnosis in a TB-endemic setting. BMC Infectious Diseases. 2012; http://hdl.handle.net/11427/15077.en_ZA
dc.language.isoengen_ZA
dc.publisherBioMed Central Ltden_ZA
dc.publisher.departmentInstitute of Infectious Disease and Molecular Medicineen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an Open Access article distributed under the terms of the Creative Commons Attribution Licenseen_ZA
dc.rights.holder2012 Demers et al.; licensee BioMed Central Ltd.en_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/2.0en_ZA
dc.sourceBMC Infectious Diseasesen_ZA
dc.source.urihttp://www.biomedcentral.com/bmcinfectdis/en_ZA
dc.subject.othermicrobiologic diagnosisen_ZA
dc.subject.othertuberculosis (TB)en_ZA
dc.subject.othermicroscopyen_ZA
dc.titleHigh yield of culture-based diagnosis in a TB-endemic settingen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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