Nucleic acid amplification tests reduce delayed diagnosis and misdiagnosis of pulmonary tuberculosis
Journal
Scientific reports
Journal Volume
12
Journal Issue
1
Date Issued
2022
Author(s)
Feng, Jia-Yih
Lin, Chou-Jui
Chien, Shun-Tien
Lin, Chih-Bin
Huang, Wei-Chang
Lee, Chih-Hsin
Yu, Ming-Chih
Lee, Jen-Jyh
Chiang, Chen-Yuan
Abstract
The clinical impact of nucleic acid amplification (NAA) tests on reducing delayed diagnosis and misdiagnosis of pulmonary TB (PTB) has rarely been investigated. PTB patients were classified into a frontline NAA group, an add-on NAA group, and a no NAA group. The outcomes of interest were the proportion of PTB case died before anti-TB treatment, the interval between sputum examination and initiation of treatment, and misdiagnosis of PTB. A total of 2192 PTB patients were enrolled, including 282 with frontline NAA, 717 with add-on NAA, and 1193 with no NAA tests. Patients with NAA tests had a lower death rate before treatment initiation compared to those without NAA tests (1.6% vs. 4.4%, p < 0.001) in all cases. Patients with frontline NAA compared to those with add-on NAA and those without NAA, had a shorter interval between sputum examination and treatment initiation in all cases (3 days vs. 6 days (p < 0.001), vs 18 days (p < 0.001)), and less misdiagnosis in smear-positive cases (1.8% vs. 5.6% (p = 0.039), vs 6.5% (p = 0.026)). In conclusion, NAA tests help prevent death before treatment initiation. Frontline NAA tests perform better than add-on NAA and no NAA in avoiding treatment delay in all cases, and misdiagnosis of PTB in smear-positive cases.
Subjects
MYCOBACTERIUM-TUBERCULOSIS; IMPACT; MTB/RIF
Publisher
NATURE PORTFOLIO
Type
journal article