Mistaken identity: New report highlights the global impact of medical misdiagnosis

December 1, 2011, University of Toronto

Researchers have discovered that over a million people worldwide diagnosed with TB go on to develop an incurable but manageable fungal infection which is usually left untreated because it is mistaken for a recurrence of the disease.

In a new report published today in the Bulletin of the , the researchers from University of Manchester and University of Toronto say because the X-ray features and symptoms are so similar doctors often misdiagnose and prescribe the wrong treatment which can lead to tens of thousands of unnecessary deaths.

The responsible, chronic pulmonary aspergillosis (CPA), evades the immune system in the lungs progressing slowly and may lie undetected for years until symptoms (weight loss, , coughing and bleeding) start to develop. By then it is often too late to treat successfully.

50 per cent of all patients who develop it are unlikely to survive for more than five years, a similar outlook to many cancers.

Now, the report's authors are calling on the World Health Organisation and others to provide awareness training, particularly for medics in Africa, India and China where under diagnosis of CPA is even more common than in because of the burden of TB.

The team was led by Professor David Denning, Director of the National Aspergillosis Centre at the University Hospital of South Manchester. He says the report highlights huge global variations in frequency and survival (see the table below). "For example, only 17 per cent of referred CPA patients in Manchester had underlying TB compared with 93 per cent in Korea. This variation reflects differences in diagnosis and inappropriate therapy—or none at all. Identifying CPA early in patients is only possible by means of microbiological testing for Aspergillus antibodies."

Professor Donald Cole, Associate Professor & Division Head of Global Health at the University of Toronto's Dalla Lana School of Public Health, is an expert in environmental and public health. He believes doctors have probably underestimated the worldwide burden of CPA. "We based our estimates on WHO data but the information is robust in some countries but not others. Under reporting is common, especially in countries such as China."

Professor Ian Jacobs is Director of MAHSC—a partnership between the NHS in Manchester and the University of Manchester—and has recently included global as a focus for its work. He is backing the call for WHO and the leaders of countries in Asia and Africa to take action. "TB is a major scourge worldwide, and to find that over a third of a million people each year then develop an incurable and ultimately fatal fungal complication—which could be diagnosed and treated—demands action."

Explore further: XPert MTB/RIF cost effective for TB diagnosis in low- and middle-income settings

More information: Bulletin of the World Health Organization 2011;89:864-872. doi: 10.2471/BLT.11.089441

Related Stories

XPert MTB/RIF cost effective for TB diagnosis in low- and middle-income settings

November 8, 2011
A study led by Frank Cobelens of the Amsterdam Institute of Global Health and Development, Amsterdam, The Netherlands and colleagues reports on the cost-effectiveness of implementing the Xpert MTB/RIF diagnostic test for ...

Drug-resistance fears for deadly fungal disease

May 5, 2011
Deadly human fungal infections caused by certain strains of Aspergillus fungi appear to be developing resistance to current drug treatments at an alarming rate, say scientists.

Blood tests for active TB not accurate or cost-effective

August 10, 2011
Commercial blood serum antibody tests—widely used in India and other developing countries to diagnose active tuberculosis—are not accurate or cost-effective, according to an analysis by researchers at the Johns ...

New tuberculosis research movement needed

November 30, 2011
In this week's PLoS Medicine, Christian Lienhardt from the WHO in Geneva, Switzerland and colleagues announce that the Stop TB Partnership and the WHO Stop TB Department have launched the TB Research Movement.

Recommended for you

Flu infection study increases understanding of natural immunity

January 23, 2018
People with higher levels of antibodies against the stem portion of the influenza virus hemagglutinin (HA) protein have less viral shedding when they get the flu, but do not have fewer or less severe signs of illness, according ...

New long-acting approach for malaria therapy developed

January 22, 2018
A new study, published in Nature Communications, conducted by the University of Liverpool and the Johns Hopkins University School of Medicine highlights a new 'long acting' medicine for the prevention of malaria.

Virus shown to be likely cause of mystery polio-like illness

January 22, 2018
A major review by UNSW researchers has identified strong evidence that a virus called Enterovirus D68 is the cause of a mystery polio-like illness that has paralysed children in the US, Canada and Europe.

Creation of synthetic horsepox virus could lead to more effective smallpox vaccine

January 19, 2018
UAlberta researchers created a new synthetic virus that could lead to the development of a more effective vaccine against smallpox. The discovery demonstrates how techniques based on the use of synthetic DNA can be used to ...

Study ends debate over role of steroids in treating septic shock

January 19, 2018
The results from the largest ever study of septic shock could improve treatment for critically ill patients and save health systems worldwide hundreds of millions of dollars each year.

New approach could help curtail hospitalizations due to influenza infection

January 18, 2018
More than 700,000 Americans were hospitalized due to illnesses associated with the seasonal flu during the 2014-15 flu season, according to federal estimates. A radical new approach to vaccine development at UCLA may help ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.