Abstract
Sputum remains the most preferred specimen for detection of Mycobacterium tuberculosis due to its non-invasive method of production. Good quality sputum specimen is essential for accurate diagnosis of pulmonary tuberculosis (PTB). It is therefore imperative to assess factors that are related to the production of sputum that is of the best quality. We assessed the intrinsic and extrinsic characteristics of presumed tuberculosis patients and the quality of sputum they produced. This was a cross-sectional study in which consenting enrolled presumed tuberculosis patients were subjected to medical examination and a structured questionnaire administered to collect clinical history, demographic information, environmental and behavioral characteristics. The enrolled participants were instructed on how to collect spot and morning sputum specimens for macroscopic and microscopic assessment to determine any association. A total of 309 patients were enrolled into the study with an even distribution on gender (50.5% males). Of these, 202 (65.3%) submitted both a spot and a morning specimen for analysis. On macroscopic examination, 70% spot and 68% morning sputum were characterized as good quality (Purulent/mucoid). The factors associated (p<0.05) with quality specimen included both intrinsic and extrinsic factors. The intrinsic factors included: difficulty in breathing, presence of conjunctivitis and knowledge of the disease whereas the only extrinsic factor associated with production of good quality sputum for tuberculosis diagnosis was time taken by patient to seek tuberculosis treatment after occurrence of any of the TB symptoms. Both intrinsic and extrinsic factors affected the quality of sputum produced by presumed tuberculosis patients. Clinical and behavioral characteristics including conjunctivitis, difficulty in breathing and delay in seeking treatment were important factors that determined the production of good quality sputum specimens, while knowledge of tuberculosis disease did not compel presumed tuberculosis patients to produce good quality sputum for diagnosis of the disease.
Highlights
Tuberculosis (TB) continues to be a global public health challenge with infections exceeding the human immunodeficiency virus (HIV) and malaria and is considered the largest cause of death from a single infectious disease
The intrinsic factors included: difficulty in breathing, presence of conjunctivitis and knowledge of the disease whereas the only extrinsic factor associated with production of good quality sputum for tuberculosis diagnosis was time taken by patient to seek tuberculosis treatment after occurrence of any of the TB symptoms
Both intrinsic and extrinsic factors affected the quality of sputum produced by presumed tuberculosis patients
Summary
Tuberculosis (TB) continues to be a global public health challenge with infections exceeding the human immunodeficiency virus (HIV) and malaria and is considered the largest cause of death from a single infectious disease. Information on composition and the impact of changes in the oral–nasal cavity and lung microbiota on M. tuberculosis and how it establishes infection in the lower respiratory tract is limited [4]. This may contribute to variability of clinical manifestation of the active disease especially with mild or extensive pulmonary involvement, extra-pulmonary, or disseminated forms of TB [5]. Good quality sputum specimen is essential for accurate diagnosis of pulmonary tuberculosis (PTB). It is imperative to assess factors that are related to the production of sputum that is of the best quality
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