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Pulmonary tuberculosis in outpatients in Sabah, Malaysia: advanced disease but low incidence of HIV co-infection

Overview of attention for article published in BMC Infectious Diseases, January 2015
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Title
Pulmonary tuberculosis in outpatients in Sabah, Malaysia: advanced disease but low incidence of HIV co-infection
Published in
BMC Infectious Diseases, January 2015
DOI 10.1186/s12879-015-0758-6
Pubmed ID
Authors

Timothy William, Uma Parameswaran, Wai Khew Lee, Tsin Wen Yeo, Nicholas M Anstey, Anna P Ralph

Abstract

BackgroundTuberculosis (TB) is generally well controlled in Malaysia, but remains an important problem in the nation¿s eastern states. In order to better understand factors contributing to high TB rates in the eastern state of Sabah, our aims were to describe characteristics of patients with TB at a large outpatient clinic, and determine the prevalence of HIV co-infection. Additionally, we sought to test sensitivity and specificity of the locally-available point-of-care HIV test kits.MethodsWe enrolled consenting adults with smear-positive pulmonary TB for a 2-year period at Luyang Clinic, Kota Kinabalu, Malaysia. Participants were questioned about ethnicity, smoking, prior TB, disease duration, symptoms and comorbidities. Chest radiographs were scored using a previously devised tool. HIV was tested after counselling using 2 point-of-care tests for each patient: the test routinely in use at the TB clinic (either Advanced Quality¿ Rapid Anti-HIV 1&2, FACTS anti-HIV 1/2 RAPID or HIV (1 + 2) Antibody Colloidal Gold), and a comparator test (Abbott Determine¿ HIV-1/2, Inverness Medical). Positive tests were confirmed by enzyme immunoassay (EIA), particle agglutination and line immunoassay.Results176 participants were enrolled; 59 (33.5%) were non-Malaysians and 104 (59.1%) were male. Smoking rates were high (81/104 males, 77.9%), most had cavitary disease (51/145, 64.8%), and 81/176 (46.0%) had haemoptysis. The median period of symptoms prior to treatment onset was 8 weeks. Diabetes was present in 12. People with diabetes or other comorbidities had less severe TB, suggesting different healthcare seeking behaviours in this group. All participants consented to HIV testing: three (1.7%) were positive according to Determine¿ and EIA, but one of these tested negative on the point-of-care test available at the clinic (Advanced Quality¿ Rapid Anti-HIV 1&2). The low number of positive tests and changes in locally-available test type meant that accurate estimates of sensitivity and specificity were not possible.ConclusionPatients had advanced disease at diagnosis, long diagnostic delays, low HIV co-infection rates, high smoking rates among males, and migrants may be over-represented. These findings provide important insights to guide local TB control efforts. Caution is required in using some point-of-care HIV tests, and ongoing quality control measures are of major importance.

Twitter Demographics

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Mendeley readers

The data shown below were compiled from readership statistics for 98 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
India 1 1%
Iran, Islamic Republic of 1 1%
Netherlands 1 1%
Unknown 95 97%

Demographic breakdown

Readers by professional status Count As %
Student > Master 21 21%
Student > Bachelor 18 18%
Researcher 17 17%
Student > Ph. D. Student 11 11%
Unspecified 8 8%
Other 23 23%
Readers by discipline Count As %
Medicine and Dentistry 49 50%
Unspecified 13 13%
Social Sciences 10 10%
Nursing and Health Professions 6 6%
Immunology and Microbiology 3 3%
Other 17 17%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 01 February 2015.
All research outputs
#3,332,247
of 4,698,042 outputs
Outputs from BMC Infectious Diseases
#1,823
of 2,569 outputs
Outputs of similar age
#114,468
of 164,331 outputs
Outputs of similar age from BMC Infectious Diseases
#100
of 152 outputs
Altmetric has tracked 4,698,042 research outputs across all sources so far. This one is in the 16th percentile – i.e., 16% of other outputs scored the same or lower than it.
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