Dynamics of Cough Frequency in Adults Undergoing Treatment for Pulmonary Tuberculosis.

Autor:	Proaño A; Escuela Profesional de Medicina, Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Perú.; Laboratorio de Investigación en Enfermedades Infecciosas, Laboratorio de Investigación y Desarrollo, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia., Bravard MA; Asociación Benéfica PRISMA, Lima, Perú.; Department of General Internal Medicine, Massachusetts General Hospital, Boston, USA.; Innovation For Health And Development, Laboratory of Research and Development,Universidad Peruana Cayetano Heredia, Lima, Peru., López JW; Laboratorio de Bioinformática y Biología Molecular, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Perú.; Instituto Nacional de Salud del Niño San Borja, Lima, Perú., Lee GO; Department of Global Community Health and Behavioral Sciences, Tulane University, New Orleans, Louisiana., Bui D; Division of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson., Datta S; Innovation For Health And Development, Laboratory of Research and Development,Universidad Peruana Cayetano Heredia, Lima, Peru.; Infectious Diseases and Immunity and Wellcome Trust Imperial College Centre for Global Health Research, Imperial College London, United Kingdom., Comina G; Department of Global Community Health and Behavioral Sciences, Tulane University, New Orleans, Louisiana.; Escuela Profesional de Ingeniería Física, Facultad de Ciencias, Universidad Nacional de Ingeniería., Zimic M; Laboratorio de Investigación en Enfermedades Infecciosas, Laboratorio de Investigación y Desarrollo, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia.; Laboratorio de Bioinformática y Biología Molecular, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Perú., Coronel J; Laboratorio de Investigación en Enfermedades Infecciosas, Laboratorio de Investigación y Desarrollo, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia., Caviedes L; Laboratorio de Investigación en Enfermedades Infecciosas, Laboratorio de Investigación y Desarrollo, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia., Cabrera JL; Servicio de Neumología, Hospital Nacional Alcides Carrión,Bellavista , Peru., Salas A; Servicio de Neumología, Hospital Nacional Dos de Mayo, Lima, Peru., Ticona E; Facultad de Medicina, Univ Nacional Mayor de San Marcosersidad, Lima, Peru.; Servicio de Enfermedades Infecciosas y Tropicales, Hospital Nacional Dos de Mayo, Lima, Perú., Vu NM; Department of Internal Medicine, Cleveland Clinic, Ohio, USA., Kirwan DE; Infectious Diseases and Immunity and Wellcome Trust Imperial College Centre for Global Health Research, Imperial College London, United Kingdom., Loader MI; Infectious Diseases and Immunity and Wellcome Trust Imperial College Centre for Global Health Research, Imperial College London, United Kingdom., Friedland JS; Infectious Diseases and Immunity and Wellcome Trust Imperial College Centre for Global Health Research, Imperial College London, United Kingdom., Moore DAJ; Laboratorio de Investigación en Enfermedades Infecciosas, Laboratorio de Investigación y Desarrollo, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia.; Asociación Benéfica PRISMA, Lima, Perú.; Tuberculosis Centre, London School of Hygiene and Tropical Medicine, United Kingdom., Evans CA; Asociación Benéfica PRISMA, Lima, Perú.; Innovation For Health And Development, Laboratory of Research and Development,Universidad Peruana Cayetano Heredia, Lima, Peru.; Infectious Diseases and Immunity and Wellcome Trust Imperial College Centre for Global Health Research, Imperial College London, United Kingdom., Tracey BH; Department of Electrical and Computer Engineering, Tufts University, Medford, Massachusetts, USA., Gilman RH; Laboratorio de Investigación en Enfermedades Infecciosas, Laboratorio de Investigación y Desarrollo, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia.; Asociación Benéfica PRISMA, Lima, Perú.; Program in Global Disease Epidemiology and Control, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA.
Jazyk:	angličtina
Zdroj:	Clinical infectious diseases : an official publication of the Infectious Diseases Society of America [Clin Infect Dis] 2017 May 01; Vol. 64 (9), pp. 1174-1181.
DOI:	10.1093/cid/cix039
Abstrakt:	Background: Cough is the major determinant of tuberculosis transmission. Despite this, there is a paucity of information regarding characteristics of cough frequency throughout the day and in response to tuberculosis therapy. Here we evaluate the circadian cycle of cough, cough frequency risk factors, and the impact of appropriate treatment on cough and bacillary load. Methods: We prospectively evaluated human immunodeficiency virus-negative adults (n = 64) with a new diagnosis of culture-proven, drug-susceptible pulmonary tuberculosis immediately prior to treatment and repeatedly until treatment day 62. At each time point, participant cough was recorded (n = 670) and analyzed using the Cayetano Cough Monitor. Consecutive coughs at least 2 seconds apart were counted as separate cough episodes. Sputum samples (n = 426) were tested with microscopic-observation drug susceptibility broth culture, and in culture-positive samples (n = 252), the time to culture positivity was used to estimate bacillary load. Results: The highest cough frequency occurred from 1 pm to 2 pm, and the lowest from 1 am to 2 am (2.4 vs 1.1 cough episodes/hour, respectively). Cough frequency was higher among participants who had higher sputum bacillary load (P < .01). Pretreatment median cough episodes/hour was 2.3 (interquartile range [IQR], 1.2-4.1), which at 14 treatment days decreased to 0.48 (IQR, 0.0-1.4) and at the end of the study decreased to 0.18 (IQR, 0.0-0.59) (both reductions P < .001). By 14 treatment days, the probability of culture conversion was 29% (95% confidence interval, 19%-41%). Conclusions: Coughs were most frequent during daytime. Two weeks of appropriate treatment significantly reduced cough frequency and resulted in one-third of participants achieving culture conversion. Thus, treatment by 2 weeks considerably diminishes, but does not eliminate, the potential for airborne tuberculosis transmission. (© The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.)
Databáze:	MEDLINE
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