An assessment of nucleic acid amplification testing for active mycobacterial infection

What health impact does early versus delayed treatment of TB have on the individual and their contacts?

Delay in treatment of TB resulting from failure to diagnose TB prior to the availability of culture results is likely to prolong the duration of symptoms in the patient, with a corresponding reduction of quality of life (QoL). In addition, treatment delay increases the duration of exposure for those individuals in contact with the patient, with a corresponding increase in the risk of transmission (American Thoracic Society 1992).

None of the articles identified by the literature search to identify evidence regarding the health implications for both the patient and their contacts resulting from a delay of treatment of active TB of a duration consistent with the time required to obtain culture results (6–8 weeks) completely fulfilled the PICO criteria outlined in Table . However, three studies provided evidence of reasonable relevance to this section of the report. Ponticiello et al. (2001) and Golub et al. (2006) examined the effect of a delay in diagnosis of TB on the risk of infection among the close contacts of the patient, while van der Oest, Kelly & Hood (2004) assessed the effect of delay on patients’ treatment outcomes. The study profiles are summarised in Table (Appendix ) and an overall summary of the body of evidence is presented in Table .

Table Body of evidence matrix for studies assessing the health impact of early versus delayed treatment of TB