Lars Jørgen Østergaard

Tuberculosis case finding and mortality prediction: added value of the clinical TBscore and biomarker suPAR

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review

DOI

  • F Rudolf, Bandim Health Project, Indepth Network, Bissau, Guinea-Bissau; Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark; GloHAU, Center for Global Health, School of Public Health, Aarhus University, Aarhus, Denmark.
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  • A-J Wagner, Bandim Health Project, Indepth Network, Bissau, Guinea-Bissau; National Public Health Laboratory, Bissau, Guinea-Bissau.
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  • F M Back, Bandim Health Project, Indepth Network, Bissau, Guinea-Bissau; National Public Health Laboratory, Bissau, Guinea-Bissau.
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  • V F Gomes, Bandim Health Project, Indepth Network, Bissau, Guinea-Bissau; National Public Health Laboratory, Bissau, Guinea-Bissau.
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  • P Aaby, Bandim Health Project, Indepth Network, Bissau, Guinea-Bissau; National Public Health Laboratory, Bissau, Guinea-Bissau.
  • ,
  • Lars Jørgen Østergaard
  • J. Eugen-Olsen, Bandim Health Project, INDEPTH Network, Bissau, Guinea-Bissau; Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark.
  • ,
  • C Wejse

SETTING: A suburban area of Bissau, the capital of Guinea-Bissau; the study was conducted among presumptive pulmonary tuberculosis (prePTB) patients seeking medical care for signs and symptoms suggestive of PTB.

OBJECTIVE: To determine if a clinical TB score and a biomarker suPAR (soluble urokinase plasminogen activator receptor) have separate and composite ability to predict PTB diagnosis and mortality in prePTB patients.

DESIGN: Observational prospective follow-up study conducted from August 2010 to August 2012.

RESULTS: We included 1011 prePTB patients (mean age 34 years, 95%CI 33-35); 55% (n = 559) were female and 161 (16%) had human immunodeficiency virus (HIV) infection. Of all included patients, 10% (n = 101) were diagnosed with PTB. Mortality during follow-up was 5% (n = 48), with a mean survival time of 158 days (95%CI 27-289) in prePTB patients diagnosed with PTB vs. 144 days (95%CI 109-178) in those not diagnosed with PTB (P = 0.774). After adjusting for HIV status and age, the best separate predictor was suPAR 5 ng/ml, with a hazard ratio (HR) of 4.6 (95%CI 2.1-9.9) for mortality and 6.7 (95%CI 4.0-11.2) for TB diagnosis. All patients who died had a TBscore II + suPAR 7; the HR of the composite score for subsequent PTB diagnosis was 33.0 (95%CI 4.6-236.6).

CONCLUSION: The proposed composite score of suPAR + TBscore II 7 can improve TB case finding and clinical monitoring.

Original languageEnglish
JournalInternational Journal of Tuberculosis and Lung Disease
Volume21
Issue1
Pages (from-to)67-72
Number of pages6
ISSN1027-3719
DOIs
Publication statusPublished - 1 Jan 2017

    Research areas

  • Journal Article

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