Should Sputum Smear Examination Be Carried Out at the End of the Intensive Phase and End of Treatment in Sputum Smear Negative Pulmonary TB Patients 英文参考文献.docVIP

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Should Sputum Smear Examination Be Carried Out at the End of the Intensive Phase and End of Treatment in Sputum Smear Negative Pulmonary TB Patients 英文参考文献.doc

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ShouldSputumSmearExaminationBeCarriedOutatthe EndoftheIntensivePhaseandEndofTreatmentin SputumSmearNegativePulmonaryTBPatients? SumitMalhotra1*,SanjayP.Zodpey2,ShivaniChandra3,RamPalVashist3,SrinathSatyanaryana4, RonyZachariah5,AnthonyD.Harries6,7 1AllIndiaInstituteofMedicalSciences,NewDelhi,India,2PublicHealthEducation,PublicHealthFoundationofIndia,NewDelhi,India,3StateTBOffice,NewDelhi, India,4InternationalUnionAgainstTuberculosisandLungDiseases(TheUnion),SouthEastAsiaRegionalOffice,NewDelhi,India,5MedecinssansFrontieres,Medical Department (Operational Research), Brussels Operational Center, MSF-Luxembourg, Luxembourg, Luxembourg, 6International Union Against Tuberculosis and Lung Disease(TheUnion),Paris,France,7DepartmentofInfectiousandTropicalDiseases,LondonSchoolofHygieneandTropicalMedicine,London,UnitedKingdom Abstract Background: TheIndianguidelineson followingupsputumsmear-negativePulmonarytuberculosis (PTB)patientsdiffer from the current World Health Organization (WHO) guidelines in that the former recommends two follow up sputum examinations(onceattheendofintensivephaseandtheotherattheendoftreatment)whilethelatterrecommendsonly one follow up sputum smear microscopy examination, which is done at the end of the intensive phase. This study was conductedtoexamineiftherewasanyaddedvalueinperforminganadditionalsputumsmearexaminationattheendof treatmentwithinthecontextofanationalTBprogram. Methods: This study was a descriptive record based review conducted in nine tuberculosis (TB) units in Delhi, India. All consecutive new sputum smear-negative PTB patients registered in these nine TB units from 1st January 2009 to 31st December2009wereincludedinthestudy. Results:Of2567newsputumsmear-negativeTBpatients,1973(90%)hadsputumspecimensexaminedattheendofthe intensivephase,ofwhom36(2%)weresmear-positive:themajority(n=28)successfullycompletedtreatmentwitheither thesameorare-treatmentregimen.Attreatmentcompletion,1766(85%)patientshadsputumspecimensexamined,of whom 16