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In women with suspected TB, brief sputum-submission instruction improved sampling quality and TB detection

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M S Khan

Miss M S Khan, University of London, London, UK;



randomised controlled trial.




blinded (laboratory staff).†



specialised outpatient tuberculosis (TB) hospital in Rawalpindi, Pakistan.


3055 patients 14–75 years of age (mean age 35 y, 51% men), who had cough for >3 weeks or fever for ⩾1 month, blood in sputum, night sweating, weight loss, and loss of appetite. Exclusion criteria were history of TB diagnosis and treatment or oral steroid use ⩽3 months before presentation.


1520 patients were allocated to instruction (2 min), given in a separate room by a female health worker, before getting a sputum container from the laboratory. The instruction group was told the importance of providing a sputum rather than saliva sample and the difference between the 2, shown how to expectorate good sputum (after 3 deep breaths, cough deeply to bring up …

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  • Source of funding: DFID TB Knowledge Program.