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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT04434976
Other study ID # KY-2019TB-20
Secondary ID
Status Completed
Phase
First received
Last updated
Start date September 8, 2019
Est. completion date January 10, 2020

Study information

Verified date June 2020
Source Huashan Hospital
Contact n/a
Is FDA regulated No
Health authority
Study type Observational

Clinical Trial Summary

The purpose of the study is to collect health-seeking pathways, sociodemographic characteristics and symptoms of 400 newly diagnosed patients with bacteriologically confirmed pulmonary tuberculosis(TB).


Description:

This research is a retrospective, multicenter, case-control study. The purpose of this study is to collect and assess health-seeking pathways, sociodemographic characteristics and symptoms of 400 newly diagnosed patients with bacteriologically confirmed pulmonary tuberculosis(TB).

According to inclusion criteria and exclusion criteria, a total of 400 participants with bacteriologically confirmed TB will be recruited and acquired their health-seeking pathways in different clinical institutions of pulmonary tuberculosis. Totally, 20 TB-designated medical institutions will be conducted in depth, covering the eastern region (7), the central region (8) and the western region (5), each hospital will enroll 20 eligible patients on the basis of convenience.

The cohorts are divided into delayed diagnosis and undelayed diagnosis. The former is defined if The length from the first clinical visit date to the diagnosis confirmed date is more than 14 days. Diagnosis is confirmed by any positive result of anti fast bacteria smear, culture, histological test, and molecular detection such as GeneXpert. By offline or online interview, we aim to collect basic sociodemographic characteristics, symptoms, health-seeking pathway, including: hospital name, the date of each visit, laboratory tests and radiology evaluation results, diagnosis, treatment, medical and transportation costs. Then list the hospitals of previous consultations and trace their classification through the official website of the Health and Medical Commission. Determine whether these hospital are designated institution based on the CDC's publicity. Consult the laboratory facilities by phone.

The primary objective is to gain the median time of pulmonary tuberculosis diagnosis confirmed and the correlation between the classification of the first-visit-institution and the diagnosis delay of the pulmonary tuberculosis.

The secondary objective is to gain the bacteriology examination coverage rate: anti fast bacteria smear, tuberculosis culture, and GeneXpert; the correlation between the use of fluoroquinolones as anti-infection treatment before tuberculosis diagnosis confirmed and the diagnosis delay of the pulmonary tuberculosis; the sociodemographic characteristics of patients with or without pulmonary tuberculosis diagnosis delay; The rates of onset symptoms and its correlation to diagnosis delayed of pulmonary tuberculosis diagnosis confirmed patients.


Recruitment information / eligibility

Status Completed
Enrollment 400
Est. completion date January 10, 2020
Est. primary completion date November 2, 2019
Accepts healthy volunteers No
Gender All
Age group 15 Years and older
Eligibility Inclusion Criteria:

- Bacteriological positive: including positive AFB smear/ culture / molecular test;

- Agree to accept this survey;

Exclusion Criteria:

- HIV antibody positive and AIDS patients;

- Combined with extrapulmonary TB;

- Critically ill patients, and according to the judgment of the research physician, it is impossible to survive for more than 16 weeks;

Study Design


Related Conditions & MeSH terms


Locations

Country Name City State
China Beihai Tuberculosis Hospital Beihai Guangxi
China Changchun Infectious Diseases Hospital Changchun Jilin
China The 2th Hospital of Daqing Daqing Hei Longjiang
China Guiyang Public Health Clinical Center Guiyang Guizhou
China Hangzhou Red Cross Hospital Hangzhou Zhejiang
China Anhui Province Hospital Hefei Anhui
China The First People's Hospital of Huaihua Huaihua Hunan
China Shandong Province Chest hospital Jinan Shandong
China Southwest Medical University Affiliated Hospital Luzhou Sichuan
China Jiangxi Province Chest Hospital Nanchang Jiangxi
China Qiubei People's Hospital Qiubei Yunnan
China 905th Hospital of PLA Navy Shanghai Shanghai
China Shanghai Public Health Clinical Center Shanghai Shanghai
China The Third People's Hospital of Shenzhen Shenzhen Guangdong
China The First People's Hospital of Taicang Taicang Jiangsu
China Wenzhou Central Hospital Wenzhou Zhejiang
China Wuhan Medical Treatment Center Wuhan Hubei
China Xian Chest Hospital Xian Shanxi
China Xuzhou Infectious Diseases Hospital Huimei Liu Xuzhou Jiangsu
China Henan Province Infectious Diseases Hospital Zhengzhou Henan

Sponsors (1)

Lead Sponsor Collaborator
Huashan Hospital

Country where clinical trial is conducted

China, 

References & Publications (10)

Farhat MR, Jacobson KR, Franke MF, Kaur D, Murray M, Mitnick CD. Fluoroquinolone Resistance Mutation Detection Is Equivalent to Culture-Based Drug Sensitivity Testing for Predicting Multidrug-Resistant Tuberculosis Treatment Outcome: A Retrospective Cohor — View Citation

GBD Tuberculosis Collaborators. Global, regional, and national burden of tuberculosis, 1990-2016: results from the Global Burden of Diseases, Injuries, and Risk Factors 2016 Study. Lancet Infect Dis. 2018 Dec;18(12):1329-1349. doi: 10.1016/S1473-3099(18)3 — View Citation

Hanson C, Osberg M, Brown J, Durham G, Chin DP. Finding the Missing Patients With Tuberculosis: Lessons Learned From Patient-Pathway Analyses in 5 Countries. J Infect Dis. 2017 Nov 6;216(suppl_7):S686-S695. doi: 10.1093/infdis/jix388. Review. — View Citation

Hanson CL, Osberg M, Brown J, Durham G, Chin DP. Conducting Patient-Pathway Analysis to Inform Programming of Tuberculosis Services: Methods. J Infect Dis. 2017 Nov 6;216(suppl_7):S679-S685. doi: 10.1093/infdis/jix387. — View Citation

Hogan CA, Puri L, Gore G, Pai M. Impact of fluoroquinolone treatment on delay of tuberculosis diagnosis: A systematic review and meta-analysis. J Clin Tuberc Other Mycobact Dis. 2016 Dec 13;6:1-7. doi: 10.1016/j.jctube.2016.12.001. eCollection 2017 Jan. — View Citation

Lewinsohn DM, Leonard MK, LoBue PA, Cohn DL, Daley CL, Desmond E, Keane J, Lewinsohn DA, Loeffler AM, Mazurek GH, O'Brien RJ, Pai M, Richeldi L, Salfinger M, Shinnick TM, Sterling TR, Warshauer DM, Woods GL. Official American Thoracic Society/Infectious D — View Citation

Liu R, Li J, Tan Y, Shang Y, Li Y, Su B, Shu W, Pang Y, Gao M, Ma L. Multicenter evaluation of the acid-fast bacillus smear, mycobacterial culture, Xpert MTB/RIF assay, and adenosine deaminase for the diagnosis of tuberculous peritonitis in China. Int J I — View Citation

Martinez L, Xu L, Chen C, Sekandi JN, Zhu Y, Zhang C, Whalen CC, Zhu L. Delays and Pathways to Final Tuberculosis Diagnosis in Patients from a Referral Hospital in Urban China. Am J Trop Med Hyg. 2017 May;96(5):1060-1065. doi: 10.4269/ajtmh.16-0358. Epub — View Citation

Mijiti P, Yuehua L, Feng X, Milligan PJ, Merle C, Gang W, Nianqiang L, Upur H. Prevalence of pulmonary tuberculosis in western China in 2010-11: a population-based, cross-sectional survey. Lancet Glob Health. 2016 Jul;4(7):e485-94. doi: 10.1016/S2214-109X — View Citation

Storla DG, Yimer S, Bjune GA. A systematic review of delay in the diagnosis and treatment of tuberculosis. BMC Public Health. 2008 Jan 14;8:15. doi: 10.1186/1471-2458-8-15. Review. — View Citation

Outcome

Type Measure Description Time frame Safety issue
Primary The median time of pulmonary tuberculosis diagnosis confirmed Time from the date of patients' symptoms onset to the date of pulmonary tuberculosis diagnosis confirmed immediately after asking the medical history and collecting the result of TB diagnosis
Primary The correlation between the classification of the first-visit-institution and the diagnosis delay of the pulmonary tuberculosis We collect the classification and the quality of the first-visit-institution of diagnosis confirmed patients by asking the past medical histories. According to the evidence of duration from symptoms onset to pulmonary TB diagnosis confirmed, use logistic correlation to find the relation between the classification of the first-visit-institution and the diagnosis delay. immediately after asking the medical history and collecting the result of TB diagnosis
Secondary Bacteriology examination coverage rate: anti fast bacteria smear, tuberculosis culture, and GeneXpert. According to the patients' health-seeking pathways, calculate the test coverage rates including anti fast bacteria smear, tuberculosis culture, and GeneXpert in different clinical institutions. The test coverage rates is acquired by recording the laboratory test reports in medical systems or paper version from patients. immediately after asking the medical history and collecting the result of TB diagnosis
Secondary The correlation between the use of fluoroquinolones as anti-infection treatment before tuberculosis diagnosis confirmed and the diagnosis delay of the pulmonary tuberculosis We collect the fluoroquinolones use evidence of each patients in different clinical institutions by asking the past medical histories and reviewing paper reports from patients as well as medical system. Then use logistic correlation to find the relation between the fluoroquinolones use history and the diagnosis delay of the pulmonary tuberculosis. immediately after asking the medical history and collecting the result of TB diagnosis
Secondary The sociodemographic characteristics of patients with or without pulmonary tuberculosis diagnosis delay. Calculating the distribution of patients' sociodemographic characteristics and correlation between results above and pulmonary tuberculosis diagnosis delay. Patients' sociodemographic characteristics includes: age, sex, marriage status, nation, occupation, education status, annual family income per capita, underlying disease such as diabetes, habits of smoking and habits of drinking alcohol. immediately after asking the medical history and collecting the result of TB diagnosis
Secondary The rates of onset symptoms and its correlation to diagnosis delayed of pulmonary tuberculosis diagnosis confirmed patients. According to the past medical history of each pulmonary tuberculosis diagnosis confirmed patients, we collect their onset symptoms and calculate the rate respectively. Then use logistic correlation to find the relation between the onset symptoms and the diagnosis delay of the pulmonary tuberculosis. immediately after asking the medical history and collecting the result of TB diagnosis