"Among HIV-infected persons with suspected TB, falsely diagnosing persons with TB by rapid testing was associated with increased mortality when compared with the group of patients who received the correct diagnosis," said study lead author Robert Blount, M.D., clinical fellow in pulmonary and critical care medicine at UCSF's School of Medicine.
The results of the study will be presented at the ATS 2010 International Conference in New Orleans, with co-authors Laurence Huang, Lucian Davis, Adithya Cattamanchi, Saskia den Boon, William Worodria and Moses Joloba also in attendance
"Tuberculosis remains a common cause of pulmonary disease worldwide," Dr. Blount said. "HIV-infected patients are particularly susceptible to TB. Diagnosis can be a challenge, because the standard test-- sputum culture—p although sensitive and specific, often takes several weeks to yield results."
Physicians and researchers have long understood that missing a positive diagnosis of tuberculosis in patients who actually have the disease can result in poor outcomes and an increase in mortality rates. But the link between mortality and false positives – diagnosing someone with tuberculosis who does not have the disease – has been less widely understood.
In this study, Dr. Blount and his colleagues evaluated the outcomes of 600 HIV-infected patients who were treated at Mulago Hospital in Kampala, Uganda, including patients who were incorrectly diagnosed with tuberculosis following rapid testing.
"Studies tend to emphasize the negative impact of missing the diagnosis of TB," Dr. Blount noted. "Our study shows that falsely diagnosing patients with TB who do not actually have TB is also associated with negative outcomes."
Dr. Blount said the poorer outcomes are likely due to the fact that patients who are misdiagnosed are treated erroneously for tuberculosis while the actual underlying condition remains untreated. Because physicians believe tuberculosis is the culprit, any search for the real underlying disease is delayed, as is proper treatment, he said.
Dr. Blount said the study's results serve to caution physicians to continue monitoring patients who have been diagnosed with tuberculosis to ensure the treatment is working, and to reassess the diagnosis if patients are not improving.
"These results remind us as clinicians that diagnostic tests are not 100 percent accurate, and that falsely diagnosing patients with a disease who do not actually have that disease can lead to negative outcomes," he said. "We must continue to re-evaluate a patient's clinical progress. If he or she is not responding as predicted to treatment for a diagnosed disease, we must entertain alternative diagnoses."
Dr. Blount also noted the results indicate a need for further refinement of rapid diagnostic tests for tuberculosis.
"These rapid tests, however, are not always as sensitive or specific for determining if a person has TB," he said. "Further research should be focused on the development of more sensitive and specific TB diagnostic tests and the clinical impact of these new tests. Ideally, these tests should be affordable enough to be used in low-income countries, where the burden of tuberculosis is high."
"The Effect of False Positive and False Negative Microscopy Results on Mortality Among HIV-Infected Ugandans Undergoing Evaluation for TB" (Session A93, Sunday, May 16, 1:30- 4:00 p.m., CC-Room 260-262 (Second Level), Morial Convention Center; Abstract 1654)
Keely Savoie | EurekAlert!
Team discovers how bacteria exploit a chink in the body's armor
20.01.2017 | University of Illinois at Urbana-Champaign
Rabies viruses reveal wiring in transparent brains
19.01.2017 | Rheinische Friedrich-Wilhelms-Universität Bonn
An important step towards a completely new experimental access to quantum physics has been made at University of Konstanz. The team of scientists headed by...
Yersiniae cause severe intestinal infections. Studies using Yersinia pseudotuberculosis as a model organism aim to elucidate the infection mechanisms of these...
Researchers from the University of Hamburg in Germany, in collaboration with colleagues from the University of Aarhus in Denmark, have synthesized a new superconducting material by growing a few layers of an antiferromagnetic transition-metal chalcogenide on a bismuth-based topological insulator, both being non-superconducting materials.
While superconductivity and magnetism are generally believed to be mutually exclusive, surprisingly, in this new material, superconducting correlations...
Laser-driving of semimetals allows creating novel quasiparticle states within condensed matter systems and switching between different states on ultrafast time scales
Studying properties of fundamental particles in condensed matter systems is a promising approach to quantum field theory. Quasiparticles offer the opportunity...
Among the general public, solar thermal energy is currently associated with dark blue, rectangular collectors on building roofs. Technologies are needed for aesthetically high quality architecture which offer the architect more room for manoeuvre when it comes to low- and plus-energy buildings. With the “ArKol” project, researchers at Fraunhofer ISE together with partners are currently developing two façade collectors for solar thermal energy generation, which permit a high degree of design flexibility: a strip collector for opaque façade sections and a solar thermal blind for transparent sections. The current state of the two developments will be presented at the BAU 2017 trade fair.
As part of the “ArKol – development of architecturally highly integrated façade collectors with heat pipes” project, Fraunhofer ISE together with its partners...
19.01.2017 | Event News
10.01.2017 | Event News
09.01.2017 | Event News
20.01.2017 | Awards Funding
20.01.2017 | Materials Sciences
20.01.2017 | Life Sciences