270156 Evaluation of Diagnostic Properties of the Sputum Smear versus Culture Method for Tuberculosis in an Ecuadorian Urban Public Health Facility

Tuesday, October 30, 2012

Sandra Luz Groeschel, BS , Department of Public Health Sciences, University of Texas at El Paso, El Paso, TX
Rodrigo Armijos, MD, ScD , Department of Public Health Sciences, The University of Texas at El Paso, El Paso, TX
Margaret Weigel, PhD , Department of Public Health Sciences, The University of Texas at El Paso, El Paso, TX
Bernadita Ulloa, MedTech , Investigación y Diagnóstico Microbiológico Salud Humana, Instituto Nacional de Higiene "Leopoldo Izquieta Perez", Quito, Ecuador
The accurate diagnosis and effective prevention and control of tuberculosis (TB) are major global public health challenges. Ecuador has among the highest documented TB incidence (65/100,000 inhabitants) and mortality rates in the Americas region (27/100,000 inhabitants); TB multidrug resistance is also becoming increasing common. The culture method is the preferred method of choice for diagnosing TB in the United States and many other high resource countries due to its high documented sensitivity. An added benefit is that it also can be used to detect primary TB resistance. In contrast, despite its lower diagnostic sensitivity, the sputum smear method is most often used in low resource countries with a high disease burden, including Ecuador. The main reason for this is due to its lower cost, quick turnaround time and reduced technology requirements. However, scarce data have been published comparing the diagnostic properties of the two methods in a high-volume public health care setting in Ecuador or neighboring countries. The major objective of the present study was to compare the diagnostic properties of the sputum smear with the culture method including its sensitivity, specificity, and predictive value. Data were collected on a consecutive sample of 1687 suspected TB or primary resistance cases referred during a 12-month period (1999-2000) by public health care professionals to the Instituto Nacional de Higiene “Leopoldo Izquieta Perez” National Reference Laboratory in Quito, Ecuador. The study findings have important practical application for TB diagnosis in low resource, low technology public health settings with a high patient volume.

Learning Areas:
Protection of the public in relation to communicable diseases including prevention or control
Provision of health care to the public

Learning Objectives:
1. Compare and contrast the sensitivity and specificity of sputum smear versus culture method for diagnosing pulmonary tuberculosis in a public health setting

Keywords: Tuberculosis, Developing Countries

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the principal author and evaluator in researching the literature, entering and analyzing the data for this particular project. In addition to my scientific interests, I have also been a proponent in finding a solution to the lack of political commitment in preventing communicable diseases in developing countries. Any relevant financial relationships? No
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.