The impact of sputum quality on tuberculosis diagnosis: a systematic review
METHODS: We searched PubMed, EMBASE, LILACS and the Cochrane Database to identify studies that addressed 1) the impact of sputum quality on the proportion of sputum samples with Mycobacterium tuberculosis detected using smear, culture or polymerase chain reaction (PCR); and 2) the impact of pre-sputum collection interventions on sputum quality and M. tuberculosis detection.
RESULTS: Ten studies met the eligibility criteria for review inclusion. Five studies assessed macroscopic and/or microscopic sputum quality characteristics and M. tuberculosis detection. The other five studies assessed the impact of pre-sputum collection interventions on sputum quality and M. tuberculosis detection. No studies assessed the impact of sputum quality on PCR-based diagnostic tests.
CONCLUSION: Definitive conclusions about the utility of sputum quality assessments are limited by the paucity of, and heterogeneity within, the available data. Given the potential for sputum quality assessments to enhance diagnostic yield and prevent wasteful laboratory testing, further research into this field is urgently needed.
Keywords: Mycobacterium tuberculosis; diagnostic accuracy; sputum appearance; sputum microscopy
Document Type: Research Article
Affiliations: 1: *South Western Sydney Clinical School, University of New South Wales, Sydney, †The Woolcock Institute of Medical Research, University of Sydney, Sydney, New South Wales, Australia 2: †The Woolcock Institute of Medical Research, University of Sydney, Sydney, New South Wales, Australia, ‡Department of Epidemiology and Biostatistics, McGill University, Montreal, Quebec, Canada
Publication date: 01 May 2015
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