Diagnostic Procedures, Diagnoses, and Treatment Outcomes of Patients with Presumptive Tuberculosis Pleural Effusion in Uzbekistan

Fazlkhan Abdugapparov, Ruzanna Grigoryan, Nargiza Parpieva, Sherali Massavirov, Anvar Riskiyev, Jamshid Gadoev, Mariana Buziashvili, Nestani Tukvadze, Arax Hovhannesyan and Andrei Dadu
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Fazlkhan Abdugapparov: Department of Phthisiology and Pulmonology, Tashkent Medical Academy, Farabi 2, Tashkent 100109, Uzbekistan
Ruzanna Grigoryan: Tuberculosis Research and Prevention Center, NGO, Yerevan 0023, Armenia
Nargiza Parpieva: Republican Specialized Scientific Practical Medical Center of Phthisiology and Pulmonology under Ministry of Health of the Republic of Uzbekistan, Sh. Alimov 1, Little Ring Road, Tashkent 100086, Uzbekistan
Sherali Massavirov: Department of Phthisiology and Pulmonology, Tashkent Medical Academy, Farabi 2, Tashkent 100109, Uzbekistan
Anvar Riskiyev: Republican Specialized Scientific Practical Medical Center of Phthisiology and Pulmonology under Ministry of Health of the Republic of Uzbekistan, Sh. Alimov 1, Little Ring Road, Tashkent 100086, Uzbekistan
Jamshid Gadoev: World Health Organization Country Office in Uzbekistan, 16 Tarobiy Str., Tashkent 100100, Uzbekistan
Mariana Buziashvili: Department of Scientific Research, National Center for Tuberculosis and Lung Diseases, 8 Adjara Str., 0101 Tbilisi, Georgia
Nestani Tukvadze: Department of Scientific Research, National Center for Tuberculosis and Lung Diseases, 8 Adjara Str., 0101 Tbilisi, Georgia
Arax Hovhannesyan: World Health Organization Regional Office for Europe, UN City, Marmorvej 51, DK-2100 Copenhagen, Denmark
Andrei Dadu: World Health Organization Regional Office for Europe, UN City, Marmorvej 51, DK-2100 Copenhagen, Denmark

IJERPH, 2021, vol. 18, issue 11, 1-8

Abstract: Tuberculosis (TB) pleural effusion (TPE) is the second most common manifestation of extrapulmonary TB (EPTB), which remains a great diagnostic challenge worldwide. In Uzbekistan, there has been no formal evaluation of the actual practices of diagnosing and treating TPE. Our cohort study therefore aimed to describe the frequency and types of different diagnostic procedures of TPE during 2017–2018 and assess the association of baseline characteristics and establish diagnostic methods with TB treatment outcomes. In total, 187 patients with presumptive TPE were assessed, and 149 had a confirmed diagnosis of TPE (other diagnoses included cancer n = 8, pneumonia n = 17, and 13 cases were unspecified). TB was bacteriologically confirmed in 22 (14.8%), cytologically confirmed in 64 (43.0%), and histologically confirmed in 16 (10.7%) patients. Hepatitis was the only co-morbidity significantly associated with unsuccessful treatment outcomes (RR 4.8; 95%CI: 1.44–15.98, p value 0.011). Multivariable regression analysis showed that drug-resistant TB was independently associated with unsuccessful TB treatment outcome. (RR 3.83; 95%CI: 1.05–14.02, p value 0.04). Multidisciplinary approaches are required to maximize the diagnostic accuracy of TPE and minimize the chances of misdiagnosis. TPE patients with co-infections and those with drug resistance should be more closely monitored to try and ensure successful TB treatment outcomes.

Keywords: tuberculosis; pleural effusion; diagnosis; pleural fluid aspiration; pleural biopsy; treatment outcome; SORT-IT; operational research; Uzbekistan (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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