Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 Aug;17(8):1023-8.
doi: 10.5588/ijtld.13.0061.

The utility of stool cultures for diagnosing tuberculosis in people living with the human immunodeficiency virus

G E Oramasionwu  1 , C M Heilig, N Udomsantisuk, M E Kimerling, B Eng, H D Nguyen, S Thai, C Keo, K D McCarthy, J K Varma, K P Cain
Affiliations

The utility of stool cultures for diagnosing tuberculosis in people living with the human immunodeficiency virus

G E Oramasionwu et al. Int J Tuberc Lung Dis. 2013 Aug.

Abstract

Background: Delayed diagnosis of tuberculosis (TB) increases mortality.

Objective: To evaluate whether stool culture improves the diagnosis of TB in people living with the human immunodeficiency virus (PLHIV).

Design: We analysed cross-sectional data of TB diagnosis in PLHIV in Cambodia, Thailand and Viet Nam. Logistic regression was used to assess the association between positive stool culture and TB, and to calculate the incremental yield of stool culture.

Results: A total of 1693 PLHIV were enrolled with a stool culture result. Of 228 PLHIV with culture-confirmed TB from any site, 101 (44%) had a positive stool culture; of these, 91 (90%) had pulmonary TB (PTB). After adjusting for confounding factors, a positive stool culture was associated with smear-negative (odds ratio [OR] 26, 95% confidence interval [CI] 12-58), moderately smear-positive (OR 60, 95%CI 23-159) and highly smear-positive (OR 179, 95%CI 59-546) PTB compared with no PTB. No statistically significant association existed with extra-pulmonary TB compared with no extra-pulmonary TB (OR 2, 95%CI 1-5). The incremental yield of one stool culture above two sputum cultures (5%, 95%CI 3-8) was comparable to an additional sputum culture (7%, 95%CI 4-11).

Conclusion: Nearly half of the PLHIV with TB had a positive stool culture that was strongly associated with PTB. Stool cultures may be used to diagnose TB in PLHIV.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Flowchart of participant inclusion.
Figure 2
Figure 2
Relationship between sputum bacillary concentration and positive stool culture in persons with pulmonary TB. Cochrane-Armitage test for trend P < 0.001. TB = tuberculosis.
See this image and copyright information in PMC

Comment in

References

    1. World Health Organization. Global tuberculosis control 2011. Geneva, Switzerland: WHO; 2011. WHO/HTM/TB/2011.16.
    1. Harries A, Maher D, Graham S. TB/HIV: a clinical manual. 2. Geneva, Switzerland: WHO; 2004. pp. 24–57.
    1. Lucas SB, Hounnou A, Peacock C, et al. The mortality and pathology of HIV infection in a West African city. AIDS. 1993;7:1569–1579. - PubMed
    1. Cain KP, Kanara N, Laserson KF, et al. The epidemiology of HIV-associated tuberculosis in rural Cambodia. Int J Tuberc Lung Dis. 2007;11:1008–1013. - PubMed
    1. World Health Organization. Global tuberculosis report 2012. Geneva, Switzerland: WHO; 2012. [Accessed May 2013]. WHO/HTM/TB/2012.6. http://www.who.int/tb/publications/global_report/en/index.html.

Publication types

LinkOut - more resources