Test and Treat: A New Standard for Smear-Positive Tuberculosis

View/ Open
Date
2012Author
Davis, J. Lucian
Dowdy, David W.
Boon, Saskia den
Walter, Nicholas D.
Katamba, Achilles
Cattamanchi, Adithya
Metadata
Show full item recordAbstract
Optimizing sputum smear microscopy, the principal method of tuberculosis (TB) diagnosis in
high-burden settings around the world, is a critical priority for global TB control. To improve rates
of testing, completion, and reporting, the World Health Organization (WHO) recently endorsed a
policy of same-day diagnosis of TB by microscopy. Unfortunately, the implementation of this
policy has emphasized same-day sputum collection alone, with patients required to return on a
subsequent day to collect results. We use a simple decision analysis to demonstrate that the timing
of results reporting has a greater impact on treatment initiation for smear-positive TB cases than
the timing of specimen collection. Same-day diagnosis of smear-positive TB, including sputum
collection and reporting of smear results, should be the new global standard.
Collections
- Medical and Health Sciences [3358]