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Pulmonary tuberculosis in outpatients in Sabah, Malaysia: advanced disease but low incidence of HIV co-infection

Overview of attention for article published in BMC Infectious Diseases, January 2015
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Title
Pulmonary tuberculosis in outpatients in Sabah, Malaysia: advanced disease but low incidence of HIV co-infection
Published in
BMC Infectious Diseases, January 2015
DOI 10.1186/s12879-015-0758-6
Pubmed ID
Authors

Timothy William, Uma Parameswaran, Wai Khew Lee, Tsin Wen Yeo, Nicholas M Anstey, Anna P Ralph

Abstract

BackgroundTuberculosis (TB) is generally well controlled in Malaysia, but remains an important problem in the nation¿s eastern states. In order to better understand factors contributing to high TB rates in the eastern state of Sabah, our aims were to describe characteristics of patients with TB at a large outpatient clinic, and determine the prevalence of HIV co-infection. Additionally, we sought to test sensitivity and specificity of the locally-available point-of-care HIV test kits.MethodsWe enrolled consenting adults with smear-positive pulmonary TB for a 2-year period at Luyang Clinic, Kota Kinabalu, Malaysia. Participants were questioned about ethnicity, smoking, prior TB, disease duration, symptoms and comorbidities. Chest radiographs were scored using a previously devised tool. HIV was tested after counselling using 2 point-of-care tests for each patient: the test routinely in use at the TB clinic (either Advanced Quality¿ Rapid Anti-HIV 1&2, FACTS anti-HIV 1/2 RAPID or HIV (1 + 2) Antibody Colloidal Gold), and a comparator test (Abbott Determine¿ HIV-1/2, Inverness Medical). Positive tests were confirmed by enzyme immunoassay (EIA), particle agglutination and line immunoassay.Results176 participants were enrolled; 59 (33.5%) were non-Malaysians and 104 (59.1%) were male. Smoking rates were high (81/104 males, 77.9%), most had cavitary disease (51/145, 64.8%), and 81/176 (46.0%) had haemoptysis. The median period of symptoms prior to treatment onset was 8 weeks. Diabetes was present in 12. People with diabetes or other comorbidities had less severe TB, suggesting different healthcare seeking behaviours in this group. All participants consented to HIV testing: three (1.7%) were positive according to Determine¿ and EIA, but one of these tested negative on the point-of-care test available at the clinic (Advanced Quality¿ Rapid Anti-HIV 1&2). The low number of positive tests and changes in locally-available test type meant that accurate estimates of sensitivity and specificity were not possible.ConclusionPatients had advanced disease at diagnosis, long diagnostic delays, low HIV co-infection rates, high smoking rates among males, and migrants may be over-represented. These findings provide important insights to guide local TB control efforts. Caution is required in using some point-of-care HIV tests, and ongoing quality control measures are of major importance.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 175 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Iran, Islamic Republic of 1 <1%
India 1 <1%
Netherlands 1 <1%
Unknown 172 98%

Demographic breakdown

Readers by professional status Count As %
Student > Master 40 23%
Researcher 26 15%
Student > Bachelor 24 14%
Student > Ph. D. Student 13 7%
Student > Postgraduate 10 6%
Other 26 15%
Unknown 36 21%
Readers by discipline Count As %
Medicine and Dentistry 68 39%
Nursing and Health Professions 14 8%
Social Sciences 11 6%
Agricultural and Biological Sciences 7 4%
Biochemistry, Genetics and Molecular Biology 6 3%
Other 24 14%
Unknown 45 26%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 01 February 2015.
All research outputs
#18,393,912
of 22,783,848 outputs
Outputs from BMC Infectious Diseases
#5,595
of 7,670 outputs
Outputs of similar age
#257,132
of 353,087 outputs
Outputs of similar age from BMC Infectious Diseases
#109
of 157 outputs
Altmetric has tracked 22,783,848 research outputs across all sources so far. This one is in the 11th percentile – i.e., 11% of other outputs scored the same or lower than it.
So far Altmetric has tracked 7,670 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 9.6. This one is in the 15th percentile – i.e., 15% of its peers scored the same or lower than it.
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We're also able to compare this research output to 157 others from the same source and published within six weeks on either side of this one. This one is in the 7th percentile – i.e., 7% of its contemporaries scored the same or lower than it.