ArticleBMJ open respiratory research2020
Prompt recognition of infectious pulmonary tuberculosis is critical to achieving elimination goals: a retrospective cohort study.
Article in BMJ open respiratory research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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8 citing papers in PubMed, 17 citations in OpenAlex.
- Impact of demographic and clinical information on pulmonary tuberculosis diagnosis via chest X-ray interpretation: a cross-sectional study in an Australian tertiary hospital.BMC infectious diseases · 2026Article
- Impact of the COVID-19 pandemic on tuberculosis program performance in Alberta, Canada: a population-based evaluation.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2025Article
- High prevalence and risk factors of positive sputum smear in newly diagnosed pulmonary tuberculosis patients in Vietnam.Le infezioni in medicina · 2025Article
- Global burden of tuberculosis attributable to diet low in whole grains from 1990 to 2021, with projection to 2045.Frontiers in nutrition · 2025Article
- Clinical profiles and related factors in tuberculosis patients with positive sputum smear mycobacterium tuberculosis tests.Scientific reports · 2024Article
- A cross-sectional analysis of preterm birth incidence and survival in Al Kharj, Saudi Arabia.Saudi medical journal · 2024Article
- A comparison of the chest radiographic and computed tomographic features of subclinical pulmonary tuberculosis.Scientific reports · 2022Article
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7 authors at 1 institution in 1 country.
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Abstract
introductionAll pulmonary tuberculosis (PTB) cases are presumed to be infectious to some degree. This spectrum of infectiousness is independently described by both the acid-fast bacilli smear and radiographic findings. Smear-positive patients with chest radiographic findings that are typical for adult-type PTB are believed to be most infectious. HYPOTHESIS: Characterisation of the presumed most infectious PTB case is possible by reference to readily available clinical features and laboratory results.
methodsRetrospective cohort study of adult, culture-positive PTB cases (151 smear-positive; 162 smear-negative) diagnosed between 1 January 2013 and 30 April 2017 in Canada. We describe cases according to demographic, clinical and laboratory features. We use multivariable multinomial logistic regression to estimate the relative risk ratio (RRR) with 95% CI of features associated with an outcome of smear-positive PTB, characterised by 'typical' chest radiograph findings.
resultsBeing Canadian-born, symptomatic, having a subacute duration of symptoms and broad-spectrum antibiotic prescriptions were all more commonly associated with smear-positive than smear-negative disease (36% vs 20%; 95% vs 63%; 88% vs 54%; and 59% vs 28%, respectively). After combining smear status and radiographic features, we show that smear-positive patients with typical chest radiographs were younger, had a longer duration of symptoms (RRR 2.41; 95% CI 1.01 to 5.74 and 2.93; 95% CI 1.20 to 7.11, respectively) and were less likely to be foreign-born, or have a moderate to high-risk factor for reactivation (RRR 0.40; 95% CI 0.17 to 0.92 and 0.18; 95% CI 0.04 to 0.71, respectively) compared with smear-negative patients with atypical chest radiograph findings.
conclusionA clear picture of the presumed most infectious PTB case emerges from available historical and laboratory information; vigilance for this presentation by front-line providers will support elimination strategies aimed at reducing transmission.
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