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      Guided sputum sample collection and culture contamination rates in the diagnosis of pulmonary TB Translated title: Associação entre coleta de escarro guiada e taxas de contaminação de culturas para o diagnóstico de TB pulmonar

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          Abstract

          A comparative study to evaluate contamination in cultures of morning sputum samples, comparing those collected at home under currently recommended conditions and those collected under supervision after patient orientation and education. The home and supervised collection groups produced 43 and 76 sputum samples, respectively. The contamination rate was nearly 3-times higher among samples collected at home than among those collected under supervision (37% vs. 13%, p < 0.05; OR = 0.25). The simple educational and hygiene measures described can decrease the contamination rate among sputum samples collected for diagnostic culture.

          Translated abstract

          Realizou-se um estudo comparativo para avaliar a contaminação em culturas de amostras matinais de escarro coletadas em domicílio sob condições recomendadas atualmente e amostras coletadas sob supervisão após orientação e educação dos pacientes. Os grupos de coleta domiciliar e supervisionada produziram 43 e 76 amostras, respectivamente. A taxa de contaminação foi aproximadamente 3 vezes maior nas amostras coletadas em domicílio do que naquelas coletadas sob supervisão (37% vs.13%; p < 0,05; OR = 0,25). As simples medidas educacionais e de higiene descritas podem reduzir a taxa de contaminação de amostras de escarro coletadas para culturas diagnósticas.

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          Improvement of tuberculosis case detection and reduction of discrepancies between men and women by simple sputum-submission instructions: a pragmatic randomised controlled trial.

          In several settings, women with suspected tuberculosis are less likely to test smear positive than are men. Submission of poor-quality sputum specimens by women might be one reason for the difference between the sexes. We did a pragmatic randomised controlled trial to assess the effect of sputum-submission instructions on female patients. 1494 women and 1561 men with suspected tuberculosis attending the Federal Tuberculosis Centre in Rawalpindi, Pakistan, were randomly assigned between May and July, 2005 either to receive sputum-submission guidance before specimen submission or to submit specimens without specific guidance, according to prevailing practice. Of enrolled patients, 133 (4%) declined to participate. The primary outcome measure was the proportion of instructed and non-instructed women testing smear positive. Intention-to-treat analysis was undertaken on the basis of treatment allocation. This study is registered with the International Standard Randomised Controlled Trial number 34123170. Instructed women were more likely to test smear positive than were controls (Risk ratio 1.63 [95% CI 1.19-2.22]). Instructions were associated with a higher rate of smear-positive case detection (58 [8%] in controls vs 95 [13%] in the intervention group; p=0.002), a decrease in spot-saliva submission (p=0.003), and an increase in the number of women returning with an early-morning specimen (p=0.02). In men, instructions did not have a significant effect on the proportion testing smear positive or specimen quality. In the Federal Tuberculosis Centre in Rawalpindi, lower smear positivity in women than in men was mainly a function of poor-quality specimen submission. Smear positivity in women was increased substantially by provision of brief instructions. Sputum-submission guidance might be a highly cost-effective intervention to improve smear-positive case detection and reduce the disparity between the sexes in tuberculosis control in low-income countries.
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            Global Tuberculosis Control: surveillance, planning, financing. WHO Report 2007

            (2007)
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              Informing the TB suspect for sputum sample collection and communicating laboratory results in Nicaragua: a neglected process in tuberculosis case finding

              OBJETIVO: valorar el proceso de información del paciente antes de la producción de esputo, la calidad de la muestra de esputo, y la transmisión de los resultados del examen microscópico del esputo a los sospechosos de tuberculosis (TB) en tres áreas de Nicaragua. MATERIAL Y MÉTODOS: (a) entrevistas dirigidas a sospechosos de TB cuya expectoración ha sido examinada para BK; (b) entrevistas dirigidas al personal de salud de tres áreas de estudio (c) la evaluación de la calidad de la expectoración. RESULTADOS: Un total de 115 sospechosos de TB y 33 trabajadores de la salud fueron entrevistados; 625 muestras de esputo fueron examinadas. Los resultados muestran varias debilidades en el proceso de información a los sospechosos antes de la producción de esputo. CONCLUSIÓN: Este estudio revela un aspecto del proceso de diagnóstico de la TB demasiado ignorado. Los resultados ilustran la importancia de evaluar de forma rutinaria el proceso completo de diagnóstico de la TB. Informing the TB suspect for sputum sample collection and communicating laboratory results in Nicaragua: a neglected process in tuberculosis case finding
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                jbpneu
                Jornal Brasileiro de Pneumologia
                J. bras. pneumol.
                Sociedade Brasileira de Pneumologia e Tisiologia (São Paulo )
                1806-3756
                May 2009
                : 35
                : 5
                : 460-463
                Affiliations
                [1 ] Universidade Federal do Espírito Santo Brazil
                [2 ] Universidade Federal do Espírito Santo Brazil
                [3 ] Universidade Federal do Espírito Santo Brazil
                [4 ] Case Western Reserve University
                [5 ] Universidade Federal do Espírito Santo Brazil
                Article
                S1806-37132009000500012
                10.1590/S1806-37132009000500012
                43974d1e-3fd9-4c0e-9442-309647c40a51

                http://creativecommons.org/licenses/by/4.0/

                History
                Product

                SciELO Brazil

                Self URI (journal page): http://www.scielo.br/scielo.php?script=sci_serial&pid=1806-3713&lng=en
                Categories
                RESPIRATORY SYSTEM

                Respiratory medicine
                Tuberculosis,Sputum,Culture techniques,Tuberculose,Escarro,Técnicas de cultura
                Respiratory medicine
                Tuberculosis, Sputum, Culture techniques, Tuberculose, Escarro, Técnicas de cultura

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