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Bronchial Washings in Sputum Scarce Cases of Pulmonary Tuberculosis

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT03732014
Recruitment Status : Withdrawn (Funding could not be secured)
First Posted : November 6, 2018
Last Update Posted : August 23, 2021
Sponsor:
Information provided by (Responsible Party):
Faisal Faiyaz Zuberi, Dow University of Health Sciences

Brief Summary:

This study will be conducted in Ojha Institute of Chest Diseases and Department of Medicine, Dow Medical College, Karachi both affiliated with Dow University of Health Sciences, Karachi, Pakistan after IRB approval. All patients of either gender with clinical suspicion of PTB on history, examination and CXR and not expectorating sputum or less than 1 ml will be included in the study. Patients with extra pulmonary tuberculosis, those with age < 12 years will be excluded. Demographic data of selected patients including age, gender, contact with PTB patient will be collected. Data will be entered in study proforma.

Selected patients will undergo bronchoscopy using Olympus 180 series video bronchoscope. Bronchial Wash will be done and 3 aliquots of BW samples will be collected by suctioning. One part of washing will be immediately inoculated in AFB Culture media and second will be submitted for Xpert MTB/RIF testing. Third part will be centrifuged, and sediment will be subjected to AFB microscopy after staining with Ziehl-Neelsen technique.

Results of microscopy and Xpert MTB/RIF will be collected next day, and treatment will be started if MTB comes positive, while results of AFB Culture will be collected after 6 weeks and treatment will be started if not already started on previous reports. Sensitivity/Resistance pattern will be recorded for both Xpert MTB/RIF and ABF Culture.

The sample size of 72 was taken for conduct of study. Sample size calculations were done using PASS software version 15.0. Frequency of positive tests will be calculated. Mean age will be calculated according to gender and compared by Student's t-test. Sensitivity & specificity of tests will be calculated using online calculator by VassarStats. Frequency of positive yield of Xpert MTB/RIF will be compared to that of microscopy by χ2- test. P-value of <0.05 was considered significant.


Condition or disease
Tuberculosis, Pulmonary

Detailed Description:

This cross-sectional study will be conducted in Ojha Institute of Chest Diseases and Department of Medicine, Dow Medical College, Karachi both affiliated with Dow University of Health Sciences, Karachi, Pakistan after IRB approval. Patients were informed of study protocol, benefits and risks and written consent will be taken. All patients of either gender with clinical suspicion of PTB on history, examination and CXR and not expectorating sputum or less than 1 ml will be included in the study. Patients with extra pulmonary tuberculosis, those with age < 12 years will be excluded. Demographic data of selected patients including age, gender, contact with PTB patient will be collected. Data will be entered in study proforma.

Selected patients will undergo bronchoscopy using Olympus 180 series video bronchoscope. BW will be done by instilling 60 ml of normal saline via bronchoscope and 3 aliquots of BW samples will be collected by suctioning. One part of washing will be immediately inoculated in AFB Culture media and second will be submitted for Xpert MTB/RIF testing. Third part will be centrifuged, and sediment will be subjected to AFB microscopy after staining with Ziehl-Neelsen technique.

Results of microscopy and Xpert MTB/RIF will be collected next day, and treatment will be started if MTB comes positive, while results of AFB Culture will be collected after 6 weeks and treatment will be started if not already started on previous reports. Sensitivity/Resistance pattern will be recorded for both Xpert MTB/RIF and ABF Culture.

Sample size was calculated using reported both for smear microscopy and Xpert MTB/RIF. Using the reported sensitivity of Xpert MTB/RIF of 82.4% by Rakotoarivelo R, et al and keeping the power at 95% and alpha at 0.05 the sample size for Xpert MTB/RIF is estimated as 25. For smear microscopy the reported sensitivity of 70.47% by Chowdhury R et al was used and sample size of 72 was calculated using same parameters as those for Xpert MTB/RIF. Higher sample size of 72 was taken for conduct of study. Sample size calculations were done using PASS software version 15.0. Frequency of positive tests will be calculated. Mean age will be calculated according to gender and compared by Student's t-test. Sensitivity & specificity of tests will be calculated using online calculator by VassarStats. Frequency of positive yield of Xpert MTB/RIF will be compared to that of microscopy by χ2- test. P-value of <0.05 was considered significant.

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Study Type : Observational
Actual Enrollment : 0 participants
Observational Model: Case-Only
Time Perspective: Cross-Sectional
Official Title: Comparison of Xpert MTB/RIF, Microscopy and AFB Culture in Bronchial Washings in Sputum Scarce Cases of Suspected Pulmonary Tuberculosis
Actual Study Start Date : January 2, 2019
Actual Primary Completion Date : September 1, 2019
Actual Study Completion Date : November 30, 2019

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Tuberculosis




Primary Outcome Measures :
  1. AFB Positivity [ Time Frame: 24 Hours ]
    AFB positivity on Xpert RIF/MTB, Culture & Microscopy



Information from the National Library of Medicine

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Ages Eligible for Study:   12 Years to 70 Years   (Child, Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Sampling Method:   Non-Probability Sample
Study Population
Sputum-scarce suspected pulmonary TB
Criteria

Inclusion Criteria:

  • Suspicion of Pulmonary TB on history, examination and CXR
  • Unable to produce sputum

Exclusion Criteria:

  • extra pulmonary tuberculosis

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03732014


Locations
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Pakistan
Ojha Institute of Chest Diseases
Karachi, Sindh, Pakistan
Sponsors and Collaborators
Faisal Faiyaz Zuberi
Investigators
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Study Director: Bader F Zuberi, FCPS Dow University of Health Sciences
Publications:
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Responsible Party: Faisal Faiyaz Zuberi, Associate Professor Pulmonology, Dow University of Health Sciences
ClinicalTrials.gov Identifier: NCT03732014    
Other Study ID Numbers: BrWash
First Posted: November 6, 2018    Key Record Dates
Last Update Posted: August 23, 2021
Last Verified: August 2021
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by Faisal Faiyaz Zuberi, Dow University of Health Sciences:
Bronchial wash
Xpert MTB/RIF
AFB Culture
AFB microscopy
Bronchoscopy
Additional relevant MeSH terms:
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Tuberculosis
Tuberculosis, Pulmonary
Mycobacterium Infections
Actinomycetales Infections
Gram-Positive Bacterial Infections
Bacterial Infections
Bacterial Infections and Mycoses
Infections
Respiratory Tract Infections
Lung Diseases
Respiratory Tract Diseases