Attention!!! Is 2 weeks cough symptoms is enough or still 3 weeks cough symptoms can assess tuberculosis
A prospective cross sectional study was conducted in the Department of Medicine, Christian Medical College and Hospital and Civil Hospital, Ludhiana. Patients between the age group 18-70 years were included in the study. 790 patients were taken for the study. Numbers of males were 65.4% and females 34.6%. In the study, it was found that in patients with 2 weeks cough duration, sputum AFB was positive at 2 weeks as well as 3 weeks. But in those patients who were negative at 2 weeks duration, when they were re-examined at 3rd week, the positivity of sputum AFB had increased which was statistically significant. So sputum analysis at 3 weeks is better than 2 weeks for tuberculosis evaluation, although evaluation of sputum should be done early at 2 weeks, cough duration for early diagnosis and treatment initiation.
Raviglione MC, O’Brien RJ,Anthony S, Fauci, Dennis L, Kasper, Dan L. Longo, Eugene Braunwald, Stephen L. Hauser, J. Larry Jaeson (2008). Mycobacterial Diseases – Tuberculosis: Harrison’s Principle of Medicine, McGraw Hill, New York, Volume 1, 17th Edition, Chapter 158 (Eds.),1006-1020.
Gopi PG, Subramani R, Santha T, Chandrasekaran V, Kolapan C, Selvakumar N, et al(2005) : Estimation of burden of tuberculosis in India for the year 2000. Indian J Med Res; 122: 243-248.
Chadha VK: Tuberculosis epidemiology in India: a review (2005) . Int J Tuberc Lung Dis; 9 (10): 1072-1082.
Santha T, Garg R, Subramani R, Chandrasekaran V, Selvakumar N. et al (2005): Comparison of cough of 2 and 3 weeks to improve detection of smear-positive tuberculosis cases among out-patients in India. Int J Tuberc Lung Dis; 9 (1): 61-68.
Golub JE, Mohan CI, Comstock GW, Chaisson RE (2005). Active case finding of tuberculosis: historical perspective and future prospects. Int J Tuberc Lung Dis; 9 (11): 1183-1203.
English RG, Bachmann MO, Bateman ED, Zwarenstein MF, Fairall SR, Bheekie A, et al (2006). Diagnostic accuracy of an integrated respiratory guideline in identifying patients with respiratory symptoms requiring screening for pulmonary tuberculosis: a cross-sectional study. BMC Pulm Med; 6: 22.
Harris AD, Mphasa NM, Mundy C, Banerjee A, Kwanjana JH, Salaniponi FML (2000) Screening tuberculosis suspects using two sputum smears. Int J Tuberc Lung Dis; 4 (1): 36-40.
Ozkutuk A, Terek G, Coban H, Esen N (2007). Is it valuable to examine more than one sputum smear per patient for the diagnosis of pulmonary tuberculosis? Jpn J Infect Dis; 60: 73-75.
Yasin MA, Cuevas LE (2003). How many sputum smears are necessary for case finding in pulmonary tuberculosis? Tropical Medicine and International Health; 8 (10): 927-932.
Gopi PG, Subramani R, Selvakumar N, Santha T, Eusuff SI, Narayanan PR (2004). Smear examination of two specimens for diagnosis of pulmonary tuberculosis in Tiruvallur District, South India. Int J Tuberc Lung Dis; 8 (7): 824-828.
Sarin R, Mukerjee S, Singla N, Sharma PP (2001). Diagnosis of tuberculosis under RNTCP examination of two or three sputum specimens. Ind J Tub; 48: 13-16.
Thomas A, Chandrasekaran V, Joseph P, Rao VB, Patil AB et al (2008). Increased yield of smear positive pulmonary TB cases by screening patients with > 2 weeks cough, compared to > 3 weeks and adequacy of 2 sputum smear examinations for diagnosis. Indian J Tuberc; 55: 77-83.