Linguissi Laure Stella Ghoma, Vouvoungui Christevy Jeannhey, Poulain Pierre, Essassa Gaston Bango, Kwedi Sylvie, Ntoumi Francine
Fondation Congolaise pour la Recherche Médicale, Cité OMS, villa D6, Djoué, Brazzaville, Republic of Congo.
Centre de Recherche Biomoleculaire Pietro Annigoni (CERBA), Labiogene, Université de Ouagadougou, 01 BP 364, Ouaga 01, Burkina Faso.
BMC Res Notes. 2015 Dec 18;8:804. doi: 10.1186/s13104-015-1774-8.
The diagnosis of pulmonary tuberculosis (PTB) and smear-negative pulmonary tuberculosis (SNPT) in resource-limited countries is often solely based on clinical signs, chest X-ray radiography and sputum smear microscopy. We investigated currently used methods for the routine diagnosis of SNPT in the Republic of Congo (RoC) among TB suspected patients. The specific case of HIV positive patients was also studied.
A cross-sectional study was conducted at the anti-tuberculosis center (CAT) of Brazzaville, RoC. Tuberculosis suspects were examined for physical signs of TB. Clinical signs, results from sputum smear microscopy, tuberculin skin test (TST) and chest X-ray were recorded.
Of the 772 enrolled participants, 372 were diagnosed PTB. Cough was a common symptom for PTB and no PTB patients. Pale skin, positive TST, weight loss and chest X-ray with abnormalities compatible with PTB (PTB-CXR) were significant indicators of PTB. Thirty-six percent of PTB patients were diagnosed SNPT. This category of patients presented less persistent cough and less PTB-CXR. Anorexia and asthenia were significant indicators of SNPT. In the case of HIV+ patients, 57% were SNPT with anorexia, asthenia and shorter cough being strong indicators of SNPT.
Chest X-ray abnormalities, weight loss, pale skin and positive TST were significant indicators of PTB. Anorexia and asthenia showed good diagnostic performance for SNPT, which deserve to be recommended as index indicators of SNPT diagnosis. Duration of cough is also a relevant indicator, especially for HIV+ patients.
在资源有限的国家，肺结核（PTB）和涂片阴性肺结核（SNPT）的诊断通常仅基于临床体征、胸部X光摄影和痰涂片显微镜检查。我们调查了刚果共和国（RoC）结核病疑似患者中目前用于SNPT常规诊断的方法。还研究了HIV阳性患者的具体情况。
在RoC布拉柴维尔的抗结核中心（CAT）进行了一项横断面研究。对结核病疑似患者进行结核病体征检查。记录临床体征、痰涂片显微镜检查结果、结核菌素皮肤试验（TST）和胸部X光检查结果。
在772名登记参与者中，372人被诊断为PTB。咳嗽是PTB患者和非PTB患者的常见症状。皮肤苍白、TST阳性、体重减轻和胸部X光检查显示与PTB相符的异常（PTB-CXR）是PTB的重要指标。36%的PTB患者被诊断为SNPT。这类患者咳嗽持续时间较短，PTB-CXR较少。厌食和乏力是SNPT的重要指标。在HIV+患者中，57%为SNPT，厌食、乏力和咳嗽时间较短是SNPT的有力指标。
胸部X光异常、体重减轻、皮肤苍白和TST阳性是PTB的重要指标。厌食和乏力对SNPT具有良好的诊断性能，值得推荐作为SNPT诊断的指标。咳嗽持续时间也是一个相关指标，尤其是对于HIV+患者。
