Screening for TB by Sputum Culture in High-Risk Groups in Copenhagen, Denmark: A Novel & Promising Approach
INTRODUCTION:
Evidence
on screening high-risk groups for TB by mobile X-ray in low-incidence countries
is building, but knowledge on other possible screening methods is limited. In
this retrospective study we report results from a community based programme
screening for TB by spot sputum culture.
METHODS:
On seven
occasions, from September 2012 through June 2014, we offered TB screening to
all persons present at 11 locations where socially marginalised people gather
in Copenhagen. Spot sputum samples from participants were examined by smear
microscopy and culture. Genotype, nucleic acid amplification test and chest
X-ray were done if TB was found.
RESULTS:
Among
1075 participants, we identified 36 cases of TB. Twenty-four cases (66.7%) were
identified at the first screening of each participant, that is, the prevalence
of TB was 2233/100 000. Thirty-five (97%) of the TB cases were culture-positive
and seven (19.4%) were smear-positive. Twelve out of 21 (57.1%) cases tested
were nucleic acid amplification test positive. Twenty-eight (77.8%) had chest
X-ray suggestive of TB. All patients with TB started treatment, 30 (83.3%) had
a successful outcome.
DISCUSSION:
Screening
for TB by spot sputum culture is possible and a promising alternative to mobile
X-ray in a community based screening programme. 22.2% did not have chest X-ray
suggestive of TB and would not have been identified using mobile X-ray. Most of
the TB cases were smear-negative, suggesting that they were identified at an
early, less infectious stage, which is essential in order to prevent
transmission and gain infection control.
- 1Department of Respiratory Medicine, Gentofte Hospital, Hellerup, Copenhagen, Denmark.
- 2International Reference Laboratory of Mycobacteriology, Statens Serum Institut, Copenhagen, Denmark.
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