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【文摘发布】提高结核检出率的简单方法
Author: Mishal Sameer Khan MSc , Osman Dar MBBS , Charalambos Sismanidis PhD , et al
Resource:The Lancet 2007; 369:1955-1960
Summary
Background
In several settings, women with suspected tuberculosis are less likely to test smear positive than are men. Submission of poor-quality sputum specimens by women might be one reason for the difference between the sexes. We did a pragmatic randomised controlled trial to assess the effect of sputum-submission instructions on female patients.
Methods
1494 women and 1561 men with suspected tuberculosis attending the Federal Tuberculosis Centre in Rawalpindi, Pakistan, were randomly assigned between May and July, 2005 either to receive sputum-submission guidance before specimen submission or to submit specimens without specific guidance, according to prevailing practice. Of enrolled patients, 133 (4%) declined to participate. The primary outcome measure was the proportion of instructed and non-instructed women testing smear positive. Intention-to-treat analysis was undertaken on the basis of treatment allocation. This study is registered with the International Standard Randomised Controlled Trial number 34123170.
Findings
Instructed women were more likely to test smear positive than were controls (Risk ratio 1·63 [95% CI 1·19–2·22]). Instructions were associated with a higher rate of smear-positive case detection (58 [8%] in controls vs 95 [13%] in the intervention group; p=0·002), a decrease in spot-saliva submission (p=0·003), and an increase in the number of women returning with an early-morning specimen (p=0·02). In men, instructions did not have a significant effect on the proportion testing smear positive or specimen quality.
Interpretation
In the Federal Tuberculosis Centre in Rawalpindi, lower smear positivity in women than in men was mainly a function of poor-quality specimen submission. Smear positivity in women was increased substantially by provision of brief instructions. Sputum-submission guidance might be a highly cost-effective intervention to improve smear-positive case detection and reduce the disparity between the sexes in tuberculosis control in low-income countries. 本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领。 初译：
Title: Improvement of tuberculosis case detection and reduction of discrepancies between men and women by simple sputum-submission instructions: a pragmatic randomised controlled trial
提高结核检出率的简单方法
Author: Mishal Sameer Khan MSc , Osman Dar MBBS , Charalambos Sismanidis PhD , et al
Resource: The Lancet 2007; 369:1955-1960
Summary 摘要
Background
In several settings, women with suspected tuberculosis are less likely to test smear positive than are men. Submission of poor-quality sputum specimens by women might be one reason for the difference between the sexes. We did a pragmatic randomised controlled trial to assess the effect of sputum-submission instructions on female patients.
背景：几项研究表明，怀疑结核的妇女较男性更不易检测出细胞涂片阳性。女性呈交的痰液样本质量欠佳可能是性别差异的原因之一。我们进行了一项计划性的随机对照试验评估呈交女性患者痰液样本的影响。[标签:content1][标签:content2]
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作者:admin@医学,生命科学 2011-03-26 17:11
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