The Role of Microbiological and Radiological Tests in the Diagnosis of Pulmonary Tuberculosis in the Conditions of the Pandemic COVID-19

Abstract

The impact of the methods for diagnosis of pulmonary tuberculosis is perceived in the fastness in setting up the actions aiming to isolate the source infection and to treat it in due time. Objective — to establish the role of microbiological and radiological tests in diagnosis of pulmonary tuberculosis in actual epidemiological context of tuberculosis associated to the COVID-19 pandemics (2020—2022). Materials and methods. It was conducted a case-control study which included 172 patients diagnosed with pulmonary tuberculosis, as new case, distributed in two groups, the 1st group — 116 patients diagnosed through the radiological methods and the 2nd group — 56 patients, diagnosed through microbiological methods. Results and discussion. The main peculiarities of patients diagnosed with tuberculosis regardless of methods of investigation were male gender, low social and economic state and high prevalence of the harmful habits with impact on the health state. Patients diagnosed through the microbiological methods were residing more frequently in rural areas, with low accessibility to healthcare services, identified through a long-evolving symptomatology, late detection, expressiveness of the clinical symptomatology and a high rate of poor treatment outcome. Recommendations were established that systematic screening for tuberculosis should be performed in all social-vulnerable groups, fortified by the individualised therapeutic approach. Conclusions. The case-control study identified that the main peculiarities of patients diagnosed with tuberculosis regardless of methods of investigation were male gender, low social and economic state and high prevalence of harmful habits such as smoking and alcohol consumption. Patients diagnosed through the microbiological methods were residing more frequently in rural areas, with low accessibility to healthcare services, concluded through a long-lasting symptomatology, late detected forms of tuberculosis, high expressiveness of the clinical symptomatology and severe evolution, followed by a high rate of poor treatment outcomes, including death. Patients diagnosed through the radiological methods were more frequently from urban sectors, from tuberculosis clusters, with comorbidities with high risk for tuberculosis sickness, such as HIV infection, diabetes and mental disorders which constituted included in active screening programs. The lack of positive microbiological assay results was the consequence of the unilateral and limited forms of pulmonary and determined a higher rate of treatment success rate.