Nucleic acid amplification tests reduce delayed diagnosis and misdiagnosis of pulmonary tuberculosis

Jia Yih Feng; Chou Jui Lin; Jann Yuan Wang; Shun Tien Chien; Chih Bin Lin; Wei Chang Huang; Chih Hsin Lee; Chin Chung Shu; Ming Chih Yu; Jen Jyh Lee; Chen Yuan Chiang

doi:10.1038/s41598-022-16319-8

Nucleic acid amplification tests reduce delayed diagnosis and misdiagnosis of pulmonary tuberculosis

Jia Yih Feng, Chou Jui Lin, Jann Yuan Wang, Shun Tien Chien, Chih Bin Lin, Wei Chang Huang, Chih Hsin Lee, Chin Chung Shu, Ming Chih Yu, Jen Jyh Lee, Chen Yuan Chiang

Research output: Contribution to journal › Article › peer-review

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Abstract

The clinical impact of nucleic acid amplification (NAA) tests on reducing delayed diagnosis and misdiagnosis of pulmonary TB (PTB) has rarely been investigated. PTB patients were classified into a frontline NAA group, an add-on NAA group, and a no NAA group. The outcomes of interest were the proportion of PTB case died before anti-TB treatment, the interval between sputum examination and initiation of treatment, and misdiagnosis of PTB. A total of 2192 PTB patients were enrolled, including 282 with frontline NAA, 717 with add-on NAA, and 1193 with no NAA tests. Patients with NAA tests had a lower death rate before treatment initiation compared to those without NAA tests (1.6% vs. 4.4%, p < 0.001) in all cases. Patients with frontline NAA compared to those with add-on NAA and those without NAA, had a shorter interval between sputum examination and treatment initiation in all cases (3 days vs. 6 days (p < 0.001), vs 18 days (p < 0.001)), and less misdiagnosis in smear-positive cases (1.8% vs. 5.6% (p = 0.039), vs 6.5% (p = 0.026)). In conclusion, NAA tests help prevent death before treatment initiation. Frontline NAA tests perform better than add-on NAA and no NAA in avoiding treatment delay in all cases, and misdiagnosis of PTB in smear-positive cases.

Original language	English
Article number	12064
Journal	Scientific Reports
Volume	12
Issue number	1
DOIs	https://doi.org/10.1038/s41598-022-16319-8
Publication status	Published - Dec 2022

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10.1038/s41598-022-16319-8

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@article{71e7d3320ce8404d995998dc38094f80,

title = "Nucleic acid amplification tests reduce delayed diagnosis and misdiagnosis of pulmonary tuberculosis",

abstract = "The clinical impact of nucleic acid amplification (NAA) tests on reducing delayed diagnosis and misdiagnosis of pulmonary TB (PTB) has rarely been investigated. PTB patients were classified into a frontline NAA group, an add-on NAA group, and a no NAA group. The outcomes of interest were the proportion of PTB case died before anti-TB treatment, the interval between sputum examination and initiation of treatment, and misdiagnosis of PTB. A total of 2192 PTB patients were enrolled, including 282 with frontline NAA, 717 with add-on NAA, and 1193 with no NAA tests. Patients with NAA tests had a lower death rate before treatment initiation compared to those without NAA tests (1.6% vs. 4.4%, p < 0.001) in all cases. Patients with frontline NAA compared to those with add-on NAA and those without NAA, had a shorter interval between sputum examination and treatment initiation in all cases (3 days vs. 6 days (p < 0.001), vs 18 days (p < 0.001)), and less misdiagnosis in smear-positive cases (1.8% vs. 5.6% (p = 0.039), vs 6.5% (p = 0.026)). In conclusion, NAA tests help prevent death before treatment initiation. Frontline NAA tests perform better than add-on NAA and no NAA in avoiding treatment delay in all cases, and misdiagnosis of PTB in smear-positive cases.",

author = "Feng, {Jia Yih} and Lin, {Chou Jui} and Wang, {Jann Yuan} and Chien, {Shun Tien} and Lin, {Chih Bin} and Huang, {Wei Chang} and Lee, {Chih Hsin} and Shu, {Chin Chung} and Yu, {Ming Chih} and Lee, {Jen Jyh} and Chiang, {Chen Yuan}",

note = "Funding Information: This work was supported by research Grants from the Ministry of Science and Technology (Taiwan) (MOST 108-2314-B-038-122). Publisher Copyright: {\textcopyright} 2022, The Author(s).",

year = "2022",

month = dec,

doi = "10.1038/s41598-022-16319-8",

language = "English",

volume = "12",

journal = "Scientific Reports",

issn = "2045-2322",

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T1 - Nucleic acid amplification tests reduce delayed diagnosis and misdiagnosis of pulmonary tuberculosis

AU - Feng, Jia Yih

AU - Lin, Chou Jui

AU - Wang, Jann Yuan

AU - Chien, Shun Tien

AU - Lin, Chih Bin

AU - Huang, Wei Chang

AU - Lee, Chih Hsin

AU - Shu, Chin Chung

AU - Yu, Ming Chih

AU - Lee, Jen Jyh

AU - Chiang, Chen Yuan

PY - 2022/12

Y1 - 2022/12

N2 - The clinical impact of nucleic acid amplification (NAA) tests on reducing delayed diagnosis and misdiagnosis of pulmonary TB (PTB) has rarely been investigated. PTB patients were classified into a frontline NAA group, an add-on NAA group, and a no NAA group. The outcomes of interest were the proportion of PTB case died before anti-TB treatment, the interval between sputum examination and initiation of treatment, and misdiagnosis of PTB. A total of 2192 PTB patients were enrolled, including 282 with frontline NAA, 717 with add-on NAA, and 1193 with no NAA tests. Patients with NAA tests had a lower death rate before treatment initiation compared to those without NAA tests (1.6% vs. 4.4%, p < 0.001) in all cases. Patients with frontline NAA compared to those with add-on NAA and those without NAA, had a shorter interval between sputum examination and treatment initiation in all cases (3 days vs. 6 days (p < 0.001), vs 18 days (p < 0.001)), and less misdiagnosis in smear-positive cases (1.8% vs. 5.6% (p = 0.039), vs 6.5% (p = 0.026)). In conclusion, NAA tests help prevent death before treatment initiation. Frontline NAA tests perform better than add-on NAA and no NAA in avoiding treatment delay in all cases, and misdiagnosis of PTB in smear-positive cases.

AB - The clinical impact of nucleic acid amplification (NAA) tests on reducing delayed diagnosis and misdiagnosis of pulmonary TB (PTB) has rarely been investigated. PTB patients were classified into a frontline NAA group, an add-on NAA group, and a no NAA group. The outcomes of interest were the proportion of PTB case died before anti-TB treatment, the interval between sputum examination and initiation of treatment, and misdiagnosis of PTB. A total of 2192 PTB patients were enrolled, including 282 with frontline NAA, 717 with add-on NAA, and 1193 with no NAA tests. Patients with NAA tests had a lower death rate before treatment initiation compared to those without NAA tests (1.6% vs. 4.4%, p < 0.001) in all cases. Patients with frontline NAA compared to those with add-on NAA and those without NAA, had a shorter interval between sputum examination and treatment initiation in all cases (3 days vs. 6 days (p < 0.001), vs 18 days (p < 0.001)), and less misdiagnosis in smear-positive cases (1.8% vs. 5.6% (p = 0.039), vs 6.5% (p = 0.026)). In conclusion, NAA tests help prevent death before treatment initiation. Frontline NAA tests perform better than add-on NAA and no NAA in avoiding treatment delay in all cases, and misdiagnosis of PTB in smear-positive cases.

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JO - Scientific Reports

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M1 - 12064

ER -

Nucleic acid amplification tests reduce delayed diagnosis and misdiagnosis of pulmonary tuberculosis

Abstract

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