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

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dc.contributor.authorDemers, Anne-Marie
dc.contributor.authorVerver, Suzanne
dc.contributor.authorBoulle, Andrew
dc.contributor.authorWarren, Robin
dc.contributor.authorVan Helden, Paul
dc.contributor.authorBehr, Marcel A.
dc.contributor.authorCoetzee, David
dc.date.accessioned2013-06-26T13:46:01Z
dc.date.available2013-06-26T13:46:01Z
dc.date.issued2012-09
dc.date.updated2012-10-28T16:07:04Z
dc.descriptionThe original publication is available at http://www.biomedcentral.com/1471-2334/12/218en_ZA
dc.description.abstractAbstract 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.en_ZA
dc.description.versionPublishers' Versionen_ZA
dc.format.extent8 p. : ill.
dc.identifier.citationDemers, A-M. et al. 2012. High yield of culture-based diagnosis in a TB-endemic setting. BMC Infectious Diseases, 12(1):218, doi:10.1186/1471-2334-12-218.en_ZA
dc.identifier.issn1471-2334 (online)
dc.identifier.otherdoi.org/10.1186/1471-2334-12-218
dc.identifier.urihttp://hdl.handle.net/10019.1/80946
dc.language.isoen_ZAen_ZA
dc.language.rfc3066en_ZA
dc.publisherBioMed Centralen_ZA
dc.rights.holderAnne-Marie Demers et al.; licensee BioMed Central Ltd.en_ZA
dc.subjectTuberculosis -- Diagnosisen_ZA
dc.subjectTuberculosis -- Microbiologyen_ZA
dc.titleHigh yield of culture-based diagnosis in a TB-endemic settingen_ZA
dc.typeArticleen_ZA
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