Early treatment response evaluated by a clinical scoring system correlates with the prognosis of pulmonary tuberculosis patients in Ethiopia: A prospective follow-up study.
(2012) In Scandinavian Journal of Infectious Diseases 44(11). p.828-834- Abstract
- Background: In resource-limited settings the monitoring of tuberculosis (TB) patients is challenging, and early identification of TB patients with a high mortality risk is important. The aim of this study was to investigate prospectively whether early changes in a clinical scoring system (TB score) can predict treatment outcome in Ethiopian patients with pulmonary tuberculosis. Method: TB patients (n = 250) and blood donors (n = 82) were recruited prospectively at Gondar University Hospital, Ethiopia. Clinical scoring was performed using an interview-based questionnaire and clinical examination.
Results: Among TB patients (53.6% of whom were HIV co-infected) the median TB score declined from week 0 to week 2 (8... (More) - Background: In resource-limited settings the monitoring of tuberculosis (TB) patients is challenging, and early identification of TB patients with a high mortality risk is important. The aim of this study was to investigate prospectively whether early changes in a clinical scoring system (TB score) can predict treatment outcome in Ethiopian patients with pulmonary tuberculosis. Method: TB patients (n = 250) and blood donors (n = 82) were recruited prospectively at Gondar University Hospital, Ethiopia. Clinical scoring was performed using an interview-based questionnaire and clinical examination.
Results: Among TB patients (53.6% of whom were HIV co-infected) the median TB score declined from week 0 to week 2 (8 (interquartile range (IQR) 6-9) vs 4 (IQR 2-6)) and dropped to a low level at week 8, which was still significantly higher than that found in blood donors (2 (IQR 1-4) vs 0 (IQR 0-1), p < 0.0001). Patients who died had a significantly higher TB score at week 0, week 2, and week 8 than survivors. Mortality was associated with a failure to achieve a decrease greater than 25% in the TB score at 2 weeks. Baseline CD4 + cell counts (< 200 cells/mm(3)) were associated with mortality but not with initial TB score results. Conclusions: The TB score was increased during the first 2 months of treatment among patients who died. Failure to achieve a greater than 25% decrease in TB score after 2 weeks of treatment was associated with increased mortality. Repeated clinical scoring during the intensive phase of TB treatment could be useful to identify high-risk patients. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/2966900
- author
- Janols, Helena LU ; Abate, Ebba ; Idh, Jonna ; Senbeto, Meseret ; Britton, Sven ; Alemu, Shitaye ; Aseffa, Abraham ; Stendahl, Olle and Schön, Thomas
- organization
- publishing date
- 2012
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Scandinavian Journal of Infectious Diseases
- volume
- 44
- issue
- 11
- pages
- 828 - 834
- publisher
- Informa Healthcare
- external identifiers
-
- wos:000310008900004
- pmid:22812387
- scopus:84867811482
- pmid:22812387
- ISSN
- 1651-1980
- DOI
- 10.3109/00365548.2012.694468
- language
- English
- LU publication?
- yes
- id
- 6e28d896-8f3b-4bbb-8822-5eade2a27693 (old id 2966900)
- alternative location
- http://www.ncbi.nlm.nih.gov/pubmed/22812387?dopt=Abstract
- date added to LUP
- 2016-04-04 09:38:26
- date last changed
- 2022-01-29 18:48:50
@article{6e28d896-8f3b-4bbb-8822-5eade2a27693,
abstract = {{Background: In resource-limited settings the monitoring of tuberculosis (TB) patients is challenging, and early identification of TB patients with a high mortality risk is important. The aim of this study was to investigate prospectively whether early changes in a clinical scoring system (TB score) can predict treatment outcome in Ethiopian patients with pulmonary tuberculosis. Method: TB patients (n = 250) and blood donors (n = 82) were recruited prospectively at Gondar University Hospital, Ethiopia. Clinical scoring was performed using an interview-based questionnaire and clinical examination. <br/><br>
<br/><br>
Results: Among TB patients (53.6% of whom were HIV co-infected) the median TB score declined from week 0 to week 2 (8 (interquartile range (IQR) 6-9) vs 4 (IQR 2-6)) and dropped to a low level at week 8, which was still significantly higher than that found in blood donors (2 (IQR 1-4) vs 0 (IQR 0-1), p < 0.0001). Patients who died had a significantly higher TB score at week 0, week 2, and week 8 than survivors. Mortality was associated with a failure to achieve a decrease greater than 25% in the TB score at 2 weeks. Baseline CD4 + cell counts (< 200 cells/mm(3)) were associated with mortality but not with initial TB score results. Conclusions: The TB score was increased during the first 2 months of treatment among patients who died. Failure to achieve a greater than 25% decrease in TB score after 2 weeks of treatment was associated with increased mortality. Repeated clinical scoring during the intensive phase of TB treatment could be useful to identify high-risk patients.}},
author = {{Janols, Helena and Abate, Ebba and Idh, Jonna and Senbeto, Meseret and Britton, Sven and Alemu, Shitaye and Aseffa, Abraham and Stendahl, Olle and Schön, Thomas}},
issn = {{1651-1980}},
language = {{eng}},
number = {{11}},
pages = {{828--834}},
publisher = {{Informa Healthcare}},
series = {{Scandinavian Journal of Infectious Diseases}},
title = {{Early treatment response evaluated by a clinical scoring system correlates with the prognosis of pulmonary tuberculosis patients in Ethiopia: A prospective follow-up study.}},
url = {{http://dx.doi.org/10.3109/00365548.2012.694468}},
doi = {{10.3109/00365548.2012.694468}},
volume = {{44}},
year = {{2012}},
}