Impact of changing diagnostic criteria for smear-positive tuberculosis: a cohort study in Malawi

Koole, O., Munthali, L., Mhango, B., Mpunga, J., Glynn, J.R. and Crampin, A.C. (2014) Impact of changing diagnostic criteria for smear-positive tuberculosis: a cohort study in Malawi. International Journal of Tuberculosis and Lung Disease, 18(7), pp. 843-846. (doi: 10.5588/ijtld.13.0811) (PMID:24902563) (PMCID:PMC4238259)

Abstract

We assessed the impact on measured burden and outcomes of the revised World Health Organization and Malawi guidelines reclassifying people with single (including ‘scanty') positive smears as smear-positive pulmonary tuberculosis cases. In a retrospective cohort in rural Malawi, 567 (34%) of 1670 smear-positive episodes were based on single positive smears (including 176 with scanty smears). Mortality rates and the proportion starting treatment were similar in those with two positive smears or single, non-scanty smears. Those with single scanty smears had higher mortality and a lower proportion starting treatment. The reclassification will increase the reported burden substantially, but should improve treatment access.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Crampin, Professor Mia
• Authors: Koole, O., Munthali, L., Mhango, B., Mpunga, J., Glynn, J.R., and Crampin, A.C.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Public Health
• Journal Name: International Journal of Tuberculosis and Lung Disease
• Publisher: International Union Against Tuberculosis and Lung Disease
• ISSN: 1027-3719
• ISSN (Online): 1815-7920