Diagnostic accuracy of Pneumococcal Urinary Antigen (PUA) test among Malaysian hajj pilgrims admitted with pneumonia
Pneumonia is a potentially life-threatening illness which poses global health problems particularly among elderly performing hajj. Streptococcus pneumoniae has been identified as a major pathogen in pneumonia. Conventional diagnostic test has faced many limitations including difficulty in obtaining...
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| Format: | Thesis Book |
| Language: | English |
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| Summary: | Pneumonia is a potentially life-threatening illness which poses global health problems particularly among elderly performing hajj. Streptococcus pneumoniae has been identified as a major pathogen in pneumonia. Conventional diagnostic test has faced many limitations including difficulty in obtaining a good sputum sample, inconsistent value of culture performance and delayed in confirmation of diagnosis. Pneumococcal Urinary Antigen (PUA) has been reported to shorten the diagnostic time. Therefore, it is used to facilitate the diagnosis of pneumococcal pneumonia among Hajj pilgrims and it could be as an alternative rapid method. This study was conducted to determine: the clinical manifestation and laboratory findings of pneumonia, the proportion of positive PUA test and it sensitivity and specificity, the association of clinical manifestation and laboratory findings with positive PUA test and the prognostic accuracy in assessing severity of pneumonia. A cross-sectional study using universal sampling was conducted on Malaysian hajj pilgrims who were admitted to Tabung Haji (TH) medical centre in Makkah with the clinical diagnoses of pneumonia. PUA was tested using immunochromatographic method on urine sample. Cultures of clinical samples were carried out as a gold standard for diagnosis of pneumococcal pneumonia. The relevant patient's data were recorded from hospital information system. A total number of 157 respondents clinically diagnosed as pneumonia were recruited during the 2012/2013 hajj season. Pneumonia affected male more than females (55.4% and 44.6% respectively) with mean age of 69.4 (10.0) years. Cough (96.2%) was recorded as the commonest symptoms followed by fever (84.7%) and breathlessness (47.1 %). Most of pilgrims were hypertensive (60.5%) while 28.0% of them experienced diabetes, chronic obstructive pulmonary disease (25.5%) and asthma (12.7%). The prevalence of positive PUA test was 12% whereas the sensitivity of test was 100% with specificity of 87.5%. The significant associated factors of positive PUA test were diabetes (OR 2.91, 95% CI 0.83 - 33.97, p=0.045). PUA was not significantly associated with CURB-65 pneumonia severity score. The finding from the study may suggest for the use of PUA test as an alternative method in diagnosing pneumococcal pneumonia especially in diabetic patients to allow a better management of patient during hajj. |
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| Physical Description: | xv, 158 leaves: ill. (some col.); 30 cm. |
| Bibliography: | Includes bibliographical references (leaves 116-138) |