Low specificity of HIV-testing on sputum specimens kept at ambient temperatures for 4 to 7 days: a blinded comparison.

Background: HIV testing on sputum using the QraQuick HIV1/2(R) assay has high sensitivity and specificity, and holds promise for application in tuberculosis surveys. Its performance under conditions that may occur during surveys in resource-poor countries is however, unknown. We assessed, in a blinded comparison with HIV serum testing, the sensitivity and specificity of the OraQuick(R) assay for detecting HIV antibody in sputum specimens kept at ambient temperature for up to 7 days, with and without decontaminant.

Low tuberculosis notification in mountainous Vietnam is not due to low case detection: a cross-sectional survey.

Background: Studies show that tuberculosis notification declines with increasing altitude. This can be due to declining incidence or declining case detection. In Vietnam notification rates of new smear-positive tuberculosis in the central mountainous provinces (26/100,000 population) are considerably lower than in Vietnam in general (69/100,000 population).

High mortality during tuberculosis treatment does not indicate long diagnostic delays in Vietnam: a cohort study.

Background: Delay in tuberculosis diagnosis and treatment initiation may increase disease severity and mortality. In evaluations of tuberculosis control programmes high fatality rates during tuberculosis treatment, are used as an indicator of long delays in low HIV-prevalence settings. However, data for this presumed association between delay and fatality are lacking.

Mortality and failure among tuberculosis patients who did not complete treatment in Vietnam: a cohort study.

Background: Tuberculosis treatment failure and death rates are low in the Western Pacific Region, including Vietnam. However, failure or death may also occur among patients who did not complete treatment, i.e.

Delays in the diagnosis and treatment of tuberculosis patients in Vietnam: a cross-sectional study.

Background: Treatment delay is an important indicator of access to tuberculosis diagnosis and treatment. Analyses of patient delay (i.e.

Tuberculosis drug resistance and HIV infection, the Netherlands.

In the Netherlands during 1993-2001, multidrug-resistant tuberculosis among newly diagnosed patients was more frequent in those with HIV coinfection (5/308, 1.6%) than in those with no HIV infection (39/646, 0.6%; adjusted odds ratio 3.

Discrepancy between Mycobacterium tuberculosis-specific gamma interferon release assays using short and prolonged in vitro incubation.

The sensitivities of various gamma interferon release assays (IGRAs) for the detection of past latent Mycobacterium tuberculosis infection are not known. In this study, we aimed to assess the effects of various IGRA formats and in vitro incubation periods on test outcome. The results of the tuberculin skin test (TST) were compared with those of the QuantiFERON-TB Gold in-tube (QFT-GIT) test, an overnight enzyme-linked immunospot assay (ELISPOT), and a 6-day lymphocyte stimulation test (LST) by using the same M.

Steep increases in tuberculosis notification among young men in the industrialised districts of Danang, Vietnam.

Background: Tuberculosis (TB) notification is increasing among young adults in urban provinces in Vietnam, despite having achieved World Health Organization targets for treatment success and case detection.

Objectives: To identify causes for non-declining TB case rates in an urban area of Vietnam, and to describe trends in new smear-positive pulmonary TB notification by age, sex and district in the period 1999-2004 in Danang City, Vietnam.

Results: Age and sex-standardised notification rates declined by 1.

Survival and relapse rate of tuberculosis patients who successfully completed treatment in Vietnam.

Setting: Reported tuberculosis (TB) cure rates are high in Vietnam with the 8-month short-course chemotherapy regimen. However, long-term treatment outcomes are unknown.

Objective: To assess survival and relapse rates among patients successfully treated for new smear-positive pulmonary tuberculosis (PTB).

Comparison of two interferon-gamma assays and tuberculin skin test for tracing tuberculosis contacts.

Background: The tuberculin skin test (TST) has low specificity. QuantiFERON-TB Gold (QFT-G) and T-SPOT.TB are based on interferon (IFN)-gamma responses to Mycobacterium tuberculosis-specific antigens.

Antituberculosis drug resistance in the south of Vietnam: prevalence and trends.

Background: There is limited evidence that the DOTS (directly observed therapy, short course) strategy for tuberculosis (TB) control can contain the emergence and spread of drug resistance in the absence of second-line treatment. We compared drug-resistance levels between 1996 and 2001 in the south of Vietnam, an area with a well-functioning DOTS program.

Methods: Sputum specimens were collected from consecutively diagnosed patients with smear-positive TB at 40 randomly selected public TB clinics.

Tuberculosis epidemiology in six provinces of Vietnam after the introduction of the DOTS strategy.

Setting: Six provinces in Vietnam where the DOTS strategy was introduced in 1989.

Objective: To assess the impact of improved tuberculosis (TB) control on TB epidemiology in Vietnam.

Methods: Data from the surveillance system in the period 1990-2003 were analysed to assess trends of notification rates and the mean ages of notified cases.

Tuberculin skin testing in patients with HIV infection: limited benefit of reduced cutoff values.

Background: When determining eligibility for isoniazid preventive therapy of human immunodeficiency virus (HIV)-infected patients, the cutoff value of the tuberculin skin test (TST) is often reduced from an induration of 10 mm in diameter to one of 5 mm in diameter to compensate for loss of sensitivity. The effectiveness of this reduction depends on the underlying mechanism: a gradual decrease in skin test responsiveness with decreasing immunocompetence or an all-or-nothing switch to complete anergy. No published studies have assessed this directly in patients with tuberculosis.

HIV prevalence among tuberculosis patients in The Netherlands, 1993-2001: trends and risk factors.

Objectives: To describe the prevalence and predictive factors of human immunodeficiency virus (HIV) infection among tuberculosis (TB) patients in The Netherlands during the period 1993-2001.

Design: Data were obtained from the national surveillance register of all patients notified with TB (all forms) during the period of the study. In addition, records or discharge notes were checked of a random sample of 200 TB patients notified in 1995 and another 200 in 2001.

Evaluation of sputum smear microscopy in the National Tuberculosis Control Programme in the north of Vietnam.

Objective: To assess the yield of sputum smear microscopy and sex differences in the National Tuberculosis Control Programme in the north of Vietnam.

Methods: Review of registers of 30 randomly selected laboratories (26 district, 4 provincial level).

Results: The average daily workload per technician was 4.

The impact of the HIV epidemic on tuberculosis transmission in Tanzania.

Objective: To assess the impact of the HIV epidemic on tuberculosis transmission in Tanzania by estimating the trend in annual risk of tuberculosis infection (ARTI) over the period 1983-2003.

Design: Tuberculin survey among school children aged 6-14 years, randomly selected by cluster sampling.

Methods: Primary outcome was the ARTI among children without a BCG vaccination scar.

Drug resistance among smear-positive tuberculosis patients in Ho Chi Minh City, Vietnam.

Objectives: To assess the pattern of drug resistance among smear-positive tuberculosis (TB) patients in an inner city area in Vietnam.

Methods: A random sample of patients diagnosed by the national TB programme (NTP) were offered HIV testing and submitted sputum for Mycobacterium tuberculosis drug sensitivity testing.

Results: Of 1433 isolates from new patients, 360 (25%) were resistant to isoniazid (INH), 57 (4.

Treatment outcomes by drug resistance and HIV status among tuberculosis patients in Ho Chi Minh City, Vietnam.

Objective: To assess the combined effects of drug resistance, HIV infection and treatment regimen on treatment outcomes of smear-positive tuberculosis patients in Ho Chi Minh City, Vietnam.

Methods: A representative sample of patients diagnosed in 1998-2000 in 12 urban districts was offered HIV testing and submitted sputum for Mycobacterium tuberculosis culture and drug susceptibility testing. New patients were treated with 2SHRZ/6HE in nine districts and with 2SHRZ/4RH in three districts.

[Large-scale outbreak investigation for tuberculosis in Zeist].

Recently a large-scale outbreak investigation was held among customers of a supermarket in the Dutch town of Zeist after an employee was diagnosed with smear-positive pulmonary tuberculosis. About 14,000 people had a tuberculin skin test and an additional 6,000 had a chest X-ray. About 400 positive skin tests and 8 cases of active tuberculosis have been reported so far.

Value of routine chest radiography in the medical screening of internationally adopted children.

Aim: To assess the value of the routine chest radiography as part of the medical evaluation of newly arrived, internationally adopted children.

Methods: We evaluated the use of routine chest radiography (CXR) in the medical screening of 1598 internationally adopted children.

Results: CXR showed abnormalities in 128 cases: 38 of these findings were already known and/or consistent with obvious clinical signs or symptoms, and 54 had no clinical relevance.