Concept: Tuberculosis (TB) - Method of Identification
Last Updated: 2019-01-17
Definition of Tuberculosis
MCHP Tuberculosis Algorithms
1. Martens et al. (2010) and Smith et al. (2013)SAS Code
In Martens et al. (2010) and Smith et al. (2013), the average annual hospital episode rates for TB per 100,000 residents for all ages were calculated. ICD-9-CM codes 011-018 and ICD-10-CA codes A15-A19 were used to identify TB cases recorded in the Hospital Abstracts data. All diagnosis fields were included. Only those who had a diagnosis of TB were counted for this indicator. Individuals with a code of "primary tuberculosis infection" (ICD-9-CM code 010.xx - skin test for TB) were excluded.
In Martens et al., (2010) , hospital abstracts were reviewed from 1984 to 2008 and divided in five time periods. From the first time period (1984/85 - 1988/89) to the last time period (2004/05 - 2007/08), the average annual hospitalization for TB decreased from 16.67 per 100,000 residents to 12.81 per 100,000 residents.
The rates of hospitalization due to TB by income quintiles were calculated for rural and urban residents. The disparity rate ratios (DRRs) were similar across time for the urban neighborhood income quintiles, but increased significantly over time in the rural neighborhood income quintiles. The socioeconomic gap in rates of hospitalization due to TB was very high in both rural and urban neighborhood income quintiles across time, however, the gap appeared to be widening over time for rural Manitoba. For more information, read the section Hospitalization due to Tuberculosis in Martens et al., (2010) and the section Hospitalizations due to Tuberculosis in Smith et al. (2013) .2. Lix et al. (2012)
In Lix et al. (2012), the Cadham Provincial Laboratory (CPL) data from 1992/93 to 2000/01 was used to identify the total number of TB tests, the number of individuals with at least one TB test, and the frequency of positive TB tests (laboratory-confirmed cases) by fiscal year in Manitoba. Data from the CPL Clinical Microbiology Section - Results file was used to identify the number of TB tests using the acid-fast bacillus (AFB) smear. For more information on AFB, see Lab Tests Online Website - AFB Smear and Culture.
Table 1 identifies the codes used in the Clinical Microbiology Section - Results data to report the results of the AFB smear. NOTE: Results from the smear do not indicate a positive test for TB. Only the presence of Mycobacterium tuberculosis and Mycobacterium bovis in the CPL Clinical Microbiology Section - Organism data indicate a positive test for TB. Table 2 identifies the codes for these two Mycobacterium organisms. For more information on CPL, see the CADHAM Provincial Laboratory (CPL) - Overview of Services and Data concept.Table 1: Tuberculosis: Clinical Microbiology Section - Results
NOTE: All records are RECTYPE=8
AUXCD5 DESCR70 AFB ACID FAST BACILLI DETECTED ON CULTURE AFBC ACID FAST BACILLI ON CULTURE. SEE PREVIOUS REPORT AFBCF A.F.B. NOT SEEN ON SPECIMEN(S) RECEIVED. CULTURE REPORT TO FOLLOW AFBNS ACID FAST BACILLI NOT SEEN AFG ACID FAST GROWTH DETECTED RADIOMETRICALLY AFIF ACID FAST BACILLI ISOLATED AFL ACID FAST-LIKE ORGANISM ISOLATED AFNI ACID FAST BACILLI NOT ISOLATED AFS ACID FAST-LIKE ORGANISMS SEEN FAFB FEW ACID FAST BACILLI SEEN FCFB FEW ACID FAST BACILLI SEEN MAFB MANY ACID FAST BACILLI SEEN MCC MYCOBACTERIAL CULTURE IS CONTAMINATED, PLEASE REPEAT NTMI NON TUBERCULOUS MYCOBACTERIA ODR ORGANISMS DETECTED RADIOMETRICALLY ARE NOT ACID FAST BACILLI OGNT ORANGE GROWTH. NOT LIKELY M. TUBERCULOSIS ONT ORANGE GROWTH. NOT LIKELY M. TUBERCULOSIS SAFB SCREEN FOR AFB NEGATIVE, CULTURE REPORT TO FOLLOW SCOMB 10 ML. REQ. FOR TB INVEST. SPECIMENS FROM THIS PATIENT WERE COMBINED
Table 2: Tuberculosis: Clinical Microbiology Section - Organisms
NOTE: All records are RECTYPE=9
AUXCD5 DESCR40 MYC4 MYCOBACTERIUM BOVIS MYC20 MYCOBACTERIUM TUBERCULOSISComparison of Lab Data to Hospital Discharge Abstracts and Medical Services Data
TB diagnoses from the Hospital Abstracts data and the Medical Services data were compared to the CPL data. ICD-9-CM codes 010-018 and ICD-10-CA codes A15-A19 were used to identify the diagnoses of TB. The frequency of individuals with a TB diagnosis in hospital abstracts and medical services data was substantially higher than in the CPL data. The agreement between the two data sources was examined and indicated a moderate concordance. For more information on how TB was investigated in the CPL data, read the section titled Case Study #2 : Tuberculosis Tests in CPL Data and Tuberculosis Diagnoses in Hospital and Physician Billing Records in Lix et al., (2012) .
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