Sputum smear positivity grade and chest X-ray findings in tuberculosis: a cross-sectional study

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Abstract

Despite many advances in the diagnosis, screening, and rapid treatment of tuberculosis, it is still a public health concern in the world. Due to the importance of this issue in diagnosis and reduction of transmission of infection and treatment of the disease especially where this study was conducted due to the high prevalence of tuberculosis, the aim of our study was to determine the relationship between sputum smear positivity grade and chest X-ray findings in pulmonary tuberculosis patients in a hospital in southeast of Iran. This cross-sectional study was performed on all patients with pulmonary TB referencing the health centers in the Zabol city from January 1, 2015 to December 30, 2020. Sputum smear and radiographic findings of the chest X-ray were evaluated. Data was collected using a form of information and finally analyzed by SPSS 22. Out of 101 patients examined in the present study, 71 were women and 30 were men. The mean age of the patients was 62.68±13.61 years. The frequency of opacity in patients with grades 1, 2, and 3 was 71.4, 78.5, and 76.5%, respectively. Frequency of cavitation in patients with grade 1, 2 and 3 was 11.5%, 28.5% and 52.9% respectively (P value 0.001). The frequency of reticulonodular presentations in patients with grade 1, 2, and 3 was 24.2, 7.1, and 0%, respectively. In general, the results of this study showed that, with increasing grading of smears (1+, 2+, and 3+), the frequency of cavitation presentation increased significantly and the frequency of reticulonodular presentations decreased significantly. The findings of the present study can help physicians to improve TB diagnostics.

About the authors

Razieh Behzadmehr

Zabol University of Medical Sciences

Author for correspondence.
Email: razbebehzadmehr@gmail.com

Associate Professor, Department of Radiology

Iran, Islamic Republic of, Zabol

E. Nejadkehkha

Zabol University of Medical Sciences

Email: ganjresearch@gmail.com

General Physician, Department of Radiology

Iran, Islamic Republic of, Zabol

References

  1. Abedipour F., Tirabadi N.M., Khodaverdi E., Roham M. A Review of drug-resistant tuberculosis, risk factors and TB epidemiology and incidence in sistan and baluchestan province. Eur. J. Mol. Clin. Med., 2020, vol. 7, no. 11, pp. 4435–4443.
  2. Ayaz M., Shaukat F., Raja G. Ensemble learning-based automatic detection of tuberculosis in chest X-ray images using hybrid feature descriptors Phys. Eng. Sci. Med., 2021, vol. 44, no. 1, pp. 183–194. doi: 10.1007/s13246-020-00966-0
  3. Bisognin F., Amodio F., Lombardi G., Bacchi Reggiani M., Vanino E., Attard L., Tadolini M., Re M.C., Dal Monte P. Predictors of time to sputum smear conversion in patients with pulmonary tuberculosis under treatment. New Microbiol., 2019, vol. 42, no. 3, pp. 171–175.
  4. Brahmapurkar K.P., Brahmapurkar V.K., Zodpey S.P. Sputum smear grading and treatment outcome among directly observed treatment-short course patients of tuberculosis unit, Jagdalpur, Bastar. J. Family Med. Prim. Care, 2017, vol. 6, no. 2, pp. 293–296. doi: 10.4103/jfmpc.jfmpc_24_16
  5. Hassanzad M., Khalilzadeh S., Bloorsaz M.R., Velayati A.A. Diagnostic criteria in children with tuberculosis. Int. J. Mycobacteriol., 2015, vol. 4, no. 5, p. 103.
  6. Jimma W., Ghazisaeedi M., Shahmoradi L., Abdurahman A.A., Kalhori S.R.N., Nasehi M., Yazdi S., Safdari R. Prevalence of and risk factors for multidrug-resistant tuberculosis in Iran and its neighboring countries: systematic review and meta-analysis. Rev. Soc. Bras. Med. Trop., 2017, vol. 50, no. 3, pp. 287–295. doi: 10.1590/0037-8682-0002-2017
  7. Kebede W., Gudina E.K., Balay G., Abebe G. Diagnostic implications and inpatient mortality related to tuberculosis at Jimma Medical Center, southwest Ethiopia. J. Clin. Tuberc. Other Mycobact. Dis., 2021, vol. 23: 100220. doi: 10.1016/j.jctube.2021.100220
  8. Krusiński A., Grzywa-Celińska A., Szewczyk K., Grzycka-Kowalczyk L., Emeryk-Maksymiuk J., Milanowski J. Various forms of tuberculosis in patients with inflammatory bowel diseases treated with biological agents. Int. J. Inflam., 2021, vol. 2021: 6284987. doi: 10.1155/2021/6284987
  9. Kyu H.H., Maddison E.R., Henry N.J., Ledesma J.R., Wiens K.E., Reiner Jr.R., Biehl M.H., Shields C., Osgood-Zimmerman A., Ross J.M. Global, regional, and national burden of tuberculosis, 1990–2016: results from the Global Burden of Diseases, Injuries, and Risk Factors 2016 Study. Lancet Infect. Dis., vol. 18, no. 12, pp. 1329–1349. doi: 10.1016/S1473-3099(18)30625-X
  10. Marvi A., Asadi-Aliabadi M., Darabi M., Rostami-Maskopaee F., Siamian H., Abedi G. Silent changes of tuberculosis in Iran (2005–2015): A joinpoint regression analysis. J. Family Med. Prim. Care, 2017, vol. 6, no. 4, pp. 760–765. doi: 10.4103/jfmpc.jfmpc_190_17
  11. Matsuoka S., Uchiyama K., Shima H., Suzuki K., Shimura A., Sasaki Y., Yamagishi F. Relationship between CT findings of pulmonary tuberculosis and the number of acid-fast bacilli on sputum smears. Clin. Imaging., 2004, vol. 28, no. 2, pp. 119–123. doi: 10.1016/S0899-7071(03)00148-7
  12. Nakiyingi L., Bwanika J.M., Ssengooba W., Mubiru F., Nakanjako D., Joloba M.L., Mayanja-Kizza H., Manabe Y.C. Chest X-ray interpretation does not complement Xpert MTB/RIF in diagnosis of smear-negative pulmonary tuberculosis among TB-HIV co-infected adults in a resource-limited setting. BMC Infect. Dis., 2021, vol. 21, no. 1: 63. doi: 10.1186/s12879-020-05752-7
  13. Nasiri M.J., Dabiri H., Darban-Sarokhalil D., Rezadehbashi M., Zamani S. Prevalence of drug-resistant tuberculosis in Iran: systematic review and meta-analysis. Am. J. Infect. Control, 2014, vol. 42, no. 11, pp. 1212–1218. doi: 10.1016/j.ajic.2014.07.017
  14. Parcell B.J., Jarchow-MacDonald A.A., Seagar A.-L., Laurenson I.F., Prescott G.J., Lockhart M. Three year evaluation of Xpert MTB/RIF in a low prevalence tuberculosis setting: a Scottish perspective. J. Infect., 2017, vol. 74, no. 5, pp. 466–472. doi: 10.1016/j.jinf.2017.02.005
  15. Penn-Nicholson A., Hraha T., Thompson E.G., Sterling D., Mbandi S.K., Wall K.M., Fisher M., Suliman S., Shankar S., Hanekom W.A., Janjic N., Hatherill M., Kaufmann S.H.E., Sutherland J., Walzl G., De Groote M.A., Ochsner U., Zak D.E., Scriba T.J.; ACS and GC6–74 Cohort Study Groups. Discovery and validation of a prognostic proteomic signature for tuberculosis progression: a prospective cohort study. PLoS Med., 2019, vol. 16, no. 4: e1002781. doi: 10.1371/journal.pmed.1002781
  16. Saffari M., Jolandimi H.A., Sehat M., Nejad N.V., Hedayati M., Zamani M., Ghasemi A. Smear grading and the Mantoux skin test can be used to predict sputum smear conversion in patients suffering from tuberculosis. GMS Hyg. Infect. Control., 2017, vol. 12: Doc12. doi: 10.3205/dgkh000297
  17. Shankar S.U., Kumar A.M., Venkateshmurthy N.S., Nair D., Kingsbury R., Velu M., Gupta J., Ahmed J., Hiremath S., Jaiswal R.K. Implementation of the new integrated algorithm for diagnosis of drug-resistant tuberculosis in Karnataka State, India: how well are we doing? PLoS One, 2021, vol. 16, no. 1: e0244785. doi: 10.1371/journal.pone.0244785
  18. Talluri Rameshwari K., Jayashree K., Anuradha K., Raghuraj Singh Ch., Sumana K. An overview of extra pulmonary tuberculosis in smear negative cases and their analysis. Int. J. Life Sci. Pharma Res., 2021, vol. 11, no. 1, pp. 204–217. doi: 10.22376/ijpbs/lpr.2021.11.1.L204-217
  19. Wang J.Y., Lee L.N., Yu C.J., Chien Y.J., Yang P.C., Group T. Factors influencing time to smear conversion in patients with smear-positive pulmonary tuberculosis. Respirology, vol. 14, no. 7, pp. 1012–1019. doi: 10.1111/j.1440-1843.2009.01598.x
  20. WHO. Global tuberculosis report 2020: executive summary. Geneva: WHO, 2020. 232 p.
  21. Zeng J., Yang Q., Xu D., Chen Q., Huang K., Cai Y., Dai Y., Hai X., Zeng Z., Gong X. Predictive value of a five-biomarker signature to diagnose active pulmonary tuberculosis patients (preprint). 2021. doi: 10.21203/rs.3.rs-148655/v1

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Copyright (c) 2022 Behzadmehr R., Nejadkehkha E.

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