Objectives: To compare diagnostic yield of Mycobacterium tuberculosis from induced sputum (IS) and gastric lavage (GL) among children in a community setting.
Methods: Specimen collection methods for bacteriologic confirmation of pulmonary tuberculosis (PTB) were compared during a tuberculosis vaccine trial near Cape Town, South Africa (2001-2006). Children with a tuberculosis contact or compatible symptoms were investigated for suspected PTB. Diagnostic yields (95% confidence intervals, CI) from 764 paired IS and GL specimens were compared in 191 culture-confirmed cases.
Measurements and Main Results: The crude yield of M. tuberculosis was 10.4%, n = 108 by IS (5.8%) and n = 127 by GL (6.8%), in a total of 194 cases, of which 3 had incomplete IS/GL specimen pairs. Agreement between IS and GL was poor (kappa = 0.31). Comparative yield of a single IS (38%) was equivalent to a single GL (42%), with difference in yield of - 4% (CI -15 to +7%). Combined yield of same-day IS and GL (67%) was equivalent to two consecutive GL (66%), with difference in yield of 1% (-9 to 11%), but significantly greater than two consecutive IS (55%), difference in yield 12% (CI 2 to 21%). Adjusted odds of M. tuberculosis culture were increased by positive tuberculin skin test or chest radiograph.
Conclusions: In this community setting, diagnostic yield of a single IS was equivalent to a single GL. Optimal diagnostic yield may be obtained from paired IS and GL on a single day, or two GL on consecutive days.
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.