Data from: Dynamics of cough frequency in adults undergoing treatment for pulmonary tuberculosis

Proaño, A, Bravard, MA, López, JW, Lee, GO, Bui, D, Datta, S, Comina, G, Zimic, M, Coronel, J, Caviedes, L, Cabrera, JL, Salas, A, Ticona, E, Vu, NM, Kirwan, DE, Loader, MI, Friedland, JS, Moore, DAJORCID logo, Evans, CA, Tracey, BH and Gilman, RH (2017). Data from: Dynamics of cough frequency in adults undergoing treatment for pulmonary tuberculosis. [Dataset]. Dryad. https://doi.org/10.5061/dryad.gv234
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Cough is the major determinant of tuberculosis transmission. Despite this, there is a paucity of information regarding characteristics of cough frequency throughout the day and in response to tuberculosis therapy. Here we evaluate the circadian cycle of cough; cough frequency risk factors; and the impact of appropriate treatment on cough and bacillary load. Methods: We prospectively evaluated HIV-negative adults (n=64) with a new diagnosis of culture-proven, drug-susceptible pulmonary tuberculosis immediately prior to treatment and repeatedly until treatment day 62. At each time-point, participant cough was recorded (n=670) and analyzed using the Cayetano Cough Monitor. Consecutive coughs at least 2-seconds apart were counted as separate cough episodes. Sputum samples (n=426) were tested with microscopic-observation drug-susceptibility broth culture, and in culture-positive samples (n=252) the time to culture positivity was used to estimate bacillary load. Results: The highest cough frequency occurred from 1-2 p.m., and the lowest from 1-2 a.m. (2.4 versus 1.1 cough episodes/hour, respectively). Cough frequency was higher among participants who had higher sputum bacillary load (p<0.01). Pre-treatment median cough episodes/hour was 2.3 (IQR=1.2-4.1), which at 14 treatment days decreased to 0.48 (IQR=0.0-1.4) and at the end of the study decreased to 0.18 (IQR=0.0-0.59), both reductions p<0.001. By 14 treatment days, the probability of culture conversion was 29% (95% CI=19-41%). Conclusions: Coughs were most frequent during daytime. Two weeks of appropriate treatment significantly reduced cough frequency and made one-third of participants achieve culture conversion. Thus treatment by two weeks considerably diminishes but not eliminates the potential for airborne tuberculosis transmission.

Keywords

Tuberculosis, Airborne transmission, Infectiousness, Cough

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