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Int J Tuberc Lung Dis. 2018 Aug 1;22(8):863-870. doi: 10.5588/ijtld.17.0652.

Daily cough frequency in tuberculosis and association with household infection.

Author information

1
Department of Respiratory Medicine, Homerton University Hospital, London, Department of Respiratory Medicine.
2
Department of Respiratory Medicine, School of Basic & Medical Biosciences, King's College London, London.
3
Department of Respiratory Medicine, Whipps Cross University Hospital, London.
4
Blizard Institute, Barts and the London School of Medicine and Dentistry.
5
Department of Respiratory Medicine, Queen Mary University of London, London, UK.
6
Departamento de Eletrónica, Telecomunicações e Informática, Institute of Electronics and Informatics Engineering, University of Aveiro, Aveiro, Portugal.
7
Department of Respiratory Medicine, Homerton University Hospital, London.

Abstract

SETTING:

Although cough in tuberculosis (TB) is presumed to be important for transmission, there is little objective supporting evidence.

OBJECTIVE:

To describe 24-h cough frequency in a group with TB, and investigate associations with household rates of infection.

DESIGN:

Patients with a new diagnosis of pulmonary TB underwent 24-h cough frequency measurement at or just before initiation of anti-tuberculosis treatment. A group with latent Mycobacterium tuberculosis infection (LTBI) acted as controls. Rates of infection among household contacts of sputum smear-positive TB were measured using the interferon-gamma release assay and the tuberculin skin test, and compared with variables relating to the contacts themselves, and to the index case, including cough frequency.

RESULTS:

Daily cough frequency in TB patients (n = 44) was variable (geometric mean [GM] 174, interquartile range [IQR] 68-475 coughs/24 h), higher than in LTBI (n = 17; GM 19 coughs/24 h, IQR 8-53; P < 0.001), and higher during the day than overnight (GM 8.9 coughs/h, IQR 4.1-19.0 vs. GM 2.9 coughs/h, IQR 0.7-13.4; P < 0.0001). Also, 24-h cough frequency in TB was associated with sputum smear status (P = 0.040), but not smoking (P = 0.475). Multivariable logistic regression confirmed that infection in contacts was independently associated with index case sputum smear grade (P = 0.014) and cough frequency (P = 0.022).

CONCLUSION:

Measurement of 24-h cough frequency in pulmonary TB helps predict infectiousness and transmission patterns.

PMID:
29991394
DOI:
10.5588/ijtld.17.0652

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