Office of the World Health Organization Representative in India, WHO Country Office, New Delhi, India.
PLoS One. 2012;7(12):e51038. doi: 10.1371/journal.pone.0051038. Epub 2012 Dec 5.
Each follow-up during the course of tuberculosis treatment currently requires two sputum examinations. However, the incremental yield of the second sputum sample during follow-up of different types of tuberculosis patients has never been determined precisely.
To assess the incremental yield of the second sputum sample in the follow-up of tuberculosis patients under the Revised National Tuberculosis Control Programme (RNTCP) in Chhattisgarh, India.
A record review of tuberculosis (TB) patients registered in 2009 using a structured proforma from two sources, Tuberculosis and Laboratory Register, was undertaken in the six districts of Chhattisgarh, India.
In smear positive cases, of 10,048 follow-up examinations, 45 (0.5%) were found to be smear positive only on the second sputum when the result of the first sample was negative. In smear negative pulmonary and extra pulmonary TB patients, of 6,206 follow-up smear examinations, 11(0.2%) were found to be smear positive.
The incremental yield of a second smear examination was very low, indicating that examination of one sputum sample is enough during follow-up among TB patients. There is insufficient yield to support sputum smear microscopy for monitoring smear negative pulmonary TB and extra pulmonary TB patients. These results indicate that the follow-up smear microscopy can be substantially simplified with favourable resource implications.
目前，在结核病治疗过程中的每次随访都需要进行两次痰检。然而，不同类型的结核病患者随访中第二次痰样的增量收益从未被准确确定。
评估印度恰蒂斯加尔邦修订国家结核病控制规划（RNTCP）下结核病患者随访中第二次痰样的增量收益。
通过从恰蒂斯加尔邦的六个地区的结核病和实验室登记册这两个来源使用结构化表格对 2009 年登记的结核病患者的记录进行了回顾。
在涂片阳性病例中，在 10048 次随访检查中，当第一次样本结果为阴性时，有 45 次（0.5%）仅在第二次痰中发现阳性。在涂片阴性的肺和肺外结核患者中，在 6206 次随访涂片检查中，有 11 次（0.2%）发现为阳性。
第二次涂片检查的增量收益非常低，这表明在结核病患者的随访中，检查一次痰样就足够了。对于监测涂片阴性的肺和肺外结核患者，其收益不足以支持痰涂片显微镜检查。这些结果表明，随访的涂片显微镜检查可以大大简化，具有有利的资源影响。
