Management of Tuberculosis: Are the Practices Homogeneous in High-Income Countries?
Objectives: To evaluate and compare practices regarding the diagnosis, isolation measures, and treatment of tuberculosis (TB) in high-income countries and mainly in Europe.Materials and Methods: A survey was conducted from November 2018 to April 2019 within the European Society of Clinical Microbiol...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2020-09-01
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| Series: | Frontiers in Public Health |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fpubh.2020.00443/full |
| _version_ | 1819000476311486464 |
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| author | Frédéric Méchaï Hugues Cordel Lorenzo Guglielmetti Lorenzo Guglielmetti Alexandra Aubry Alexandra Aubry Mateja Jankovic Miguel Viveiros Miguel Santin Delia Goletti Emmanuelle Cambau Emmanuelle Cambau |
| author_facet | Frédéric Méchaï Hugues Cordel Lorenzo Guglielmetti Lorenzo Guglielmetti Alexandra Aubry Alexandra Aubry Mateja Jankovic Miguel Viveiros Miguel Santin Delia Goletti Emmanuelle Cambau Emmanuelle Cambau |
| author_sort | Frédéric Méchaï |
| collection | DOAJ |
| description | Objectives: To evaluate and compare practices regarding the diagnosis, isolation measures, and treatment of tuberculosis (TB) in high-income countries and mainly in Europe.Materials and Methods: A survey was conducted from November 2018 to April 2019 within the European Society of Clinical Microbiology and Infectious Diseases Study Group for Mycobacterial Infections (ESGMYC). The practices observed were compared to the main international guidelines.Results: Among 136 ESGMYC members, 64 (17 countries) responded to the questionnaire. In their practice, two (20.7%) or three sputum samples (79.3%) were collected for the diagnosis of pulmonary TB, alternatively induced sputum (n = 37, 67.2%), bronchoscopy (34, 58.6%), and gastric aspirates (15, 25.9%). Nucleic acid amplification tests (NAATs) were performed by 41 (64%) respondents whatever the smear result and by 47 (73%) in case of smear-positive specimens. NAAT and adenosine deaminase measurement were used for extrapulmonary TB diagnosis in 83.6 and 40.4% of cases, respectively. For isolation duration, 21 respondents (42.9%) were keeping isolation until smear negativity. An initial treatment without ethambutol was offered by 14% (n = 9) of respondents. Corticosteroid therapy, cerebrospinal fluid opening pressure testing, and repeated lumbar puncture were carried out for central nervous system TB by 79.6, 51.9, and 46.3% of the respondents, respectively. For patients with human immunodeficiency virus–TB coinfection, the preferred antiretroviral therapy included dolutegravir 50 mg twice a day (56.8%). Comparing with the recommendations of the main guidelines, the practices are not totally consistent.Conclusion: This study shows heterogeneous practices, particularly for diagnosis, and isolation, although rapid molecular testing is implemented in most centers. More standardization might be needed. |
| first_indexed | 2024-12-20T22:33:55Z |
| format | Article |
| id | doaj.art-aeedbf25e2e847a79b22216922f4da8d |
| institution | Directory Open Access Journal |
| issn | 2296-2565 |
| language | English |
| last_indexed | 2024-12-20T22:33:55Z |
| publishDate | 2020-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Public Health |
| spelling | doaj.art-aeedbf25e2e847a79b22216922f4da8d2022-12-21T19:24:39ZengFrontiers Media S.A.Frontiers in Public Health2296-25652020-09-01810.3389/fpubh.2020.00443504757Management of Tuberculosis: Are the Practices Homogeneous in High-Income Countries?Frédéric Méchaï0Hugues Cordel1Lorenzo Guglielmetti2Lorenzo Guglielmetti3Alexandra Aubry4Alexandra Aubry5Mateja Jankovic6Miguel Viveiros7Miguel Santin8Delia Goletti9Emmanuelle Cambau10Emmanuelle Cambau11APHP, Infectious Disease Unit, Avicenne Hospital, Université Paris 13, IAME, INSERM, Bobigny, FranceAPHP, Infectious Disease Unit, Avicenne Hospital, Université Paris 13, IAME, INSERM, Bobigny, FranceAPHP, Groupe Hospitalier Universitaire Sorbonne Université, Hôpital Pitié-Salpêtrière, Centre National de Référence des Mycobactéries et de la Résistance des Mycobactéries aux Antituberculeux, Paris, FranceSorbonne Université, INSERM, U1135, Centre d'Immunologie et des Maladies Infectieuses, Cimi-Paris, Paris, FranceAPHP, Groupe Hospitalier Universitaire Sorbonne Université, Hôpital Pitié-Salpêtrière, Centre National de Référence des Mycobactéries et de la Résistance des Mycobactéries aux Antituberculeux, Paris, FranceSorbonne Université, INSERM, U1135, Centre d'Immunologie et des Maladies Infectieuses, Cimi-Paris, Paris, FranceClinic for Lung Diseases, University of Zagreb School of Medicine and University Hospital Center Zagreb, Zagreb, CroatiaGlobal Health and Tropical Medicine, GHTM, Instituto de Higiene e Medicina Tropical, IHMT, Universidade Nova de Lisboa, UNL, Lisboa, PortugalService of Infectious Diseases, Tuberculosis Unit, Bellvitge University Hospital-IDIBELL, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, SpainTranslational Research Unit, Department of Epidemiology and Preclinical Research, “L. Spallanzani” National Institute for Infectious Diseases (INMI), IRCCS, Rome, ItalyAPHP, Groupe Hospitalier Universitaire Sorbonne Université, Hôpital Pitié-Salpêtrière, Centre National de Référence des Mycobactéries et de la Résistance des Mycobactéries aux Antituberculeux, Paris, FranceAP-HP, Hôpital Lariboisière, Service de Bactériologie, Paris, FranceObjectives: To evaluate and compare practices regarding the diagnosis, isolation measures, and treatment of tuberculosis (TB) in high-income countries and mainly in Europe.Materials and Methods: A survey was conducted from November 2018 to April 2019 within the European Society of Clinical Microbiology and Infectious Diseases Study Group for Mycobacterial Infections (ESGMYC). The practices observed were compared to the main international guidelines.Results: Among 136 ESGMYC members, 64 (17 countries) responded to the questionnaire. In their practice, two (20.7%) or three sputum samples (79.3%) were collected for the diagnosis of pulmonary TB, alternatively induced sputum (n = 37, 67.2%), bronchoscopy (34, 58.6%), and gastric aspirates (15, 25.9%). Nucleic acid amplification tests (NAATs) were performed by 41 (64%) respondents whatever the smear result and by 47 (73%) in case of smear-positive specimens. NAAT and adenosine deaminase measurement were used for extrapulmonary TB diagnosis in 83.6 and 40.4% of cases, respectively. For isolation duration, 21 respondents (42.9%) were keeping isolation until smear negativity. An initial treatment without ethambutol was offered by 14% (n = 9) of respondents. Corticosteroid therapy, cerebrospinal fluid opening pressure testing, and repeated lumbar puncture were carried out for central nervous system TB by 79.6, 51.9, and 46.3% of the respondents, respectively. For patients with human immunodeficiency virus–TB coinfection, the preferred antiretroviral therapy included dolutegravir 50 mg twice a day (56.8%). Comparing with the recommendations of the main guidelines, the practices are not totally consistent.Conclusion: This study shows heterogeneous practices, particularly for diagnosis, and isolation, although rapid molecular testing is implemented in most centers. More standardization might be needed.https://www.frontiersin.org/article/10.3389/fpubh.2020.00443/fulltuberculosissurveyEuropeguidelinesharmonizationdiagnosis |
| spellingShingle | Frédéric Méchaï Hugues Cordel Lorenzo Guglielmetti Lorenzo Guglielmetti Alexandra Aubry Alexandra Aubry Mateja Jankovic Miguel Viveiros Miguel Santin Delia Goletti Emmanuelle Cambau Emmanuelle Cambau Management of Tuberculosis: Are the Practices Homogeneous in High-Income Countries? Frontiers in Public Health tuberculosis survey Europe guidelines harmonization diagnosis |
| title | Management of Tuberculosis: Are the Practices Homogeneous in High-Income Countries? |
| title_full | Management of Tuberculosis: Are the Practices Homogeneous in High-Income Countries? |
| title_fullStr | Management of Tuberculosis: Are the Practices Homogeneous in High-Income Countries? |
| title_full_unstemmed | Management of Tuberculosis: Are the Practices Homogeneous in High-Income Countries? |
| title_short | Management of Tuberculosis: Are the Practices Homogeneous in High-Income Countries? |
| title_sort | management of tuberculosis are the practices homogeneous in high income countries |
| topic | tuberculosis survey Europe guidelines harmonization diagnosis |
| url | https://www.frontiersin.org/article/10.3389/fpubh.2020.00443/full |
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