Abstract
BACKGROUND: There is a need for low-technology, inexpensive screening tools for active tuberculosis (TB) case finding. OBJECTIVE: To assess the potential usefulness of measuring exhaled nitric oxide (eNO). DESIGN: Cross-sectional comparison in Hanoi, Viet Nam, comparing 90 consecutive smear-positive, culture-confirmed TB patients presenting at a referral hospital with office workers (no X-ray confirming TB) at this hospital (n = 52) and at a construction firm (n = 84). eNO levels were analysed using a validated handheld analyser. RESULTS: eNO levels among TB patients (median 115 parts per billion [ppb], interquartile range [IQR] 10-20) were equal to those among construction firm workers (15 ppb, IQR 12-19, P = 0.517) but higher than those among hospital workers (8.5 ppb, IQR 5-12.5, P <0.001). Taking the hospital workers as the comparison group, best performance as a diagnostic tool was at a cut-off of 10 ppb, with sensitivity 78% (95% CI 68-86) and specificity 62% (95% CI 47-75). Test characteristics could be optimised to 84% vs. 67% by excluding individuals who had recently smoked or consumed alcohol. CONCLUSION: While eNO measurement has limited value in the direct diagnosis of pulmonary TB, it may be worth developing and evaluating as a cost-effective replacement of chest X-ray in screening algorithms of pulmonary TB where X-ray is not available
| Original language | English |
|---|---|
| Pages (from-to) | 185-191 |
| Journal | International journal of tuberculosis and lung disease |
| Volume | 15 |
| Issue number | 2 |
| Publication status | Published - 2011 |