Comparison of minimally invasive tissue sampling with conventional autopsy to detect pulmonary pathology among respiratory deaths in a resource-limited setting

Drucilla J Roberts; Henry N Njuguna; Barry Fields; Corinne L Fligner; Sherif R Zaki; M Kelly Keating; Emily Rogena; Edwin Walong; Andrew K Gachii; Elizabeth Maleche-Obimbo; Grace Irimu; John Mathaiya; Noelle Orata; Rosemarie Lopokoiyit; Jackson Michuki; Gideon O Emukule; Clayton O Onyango; Stella Gikunju; Collins Owuor; Peter K Muturi; Milka Bunei; Marc-Alain Widdowson; Joshua A Mott; Sandra S Chaves

doi:10.1093/ajcp/aqz016

Comparison of minimally invasive tissue sampling with conventional autopsy to detect pulmonary pathology among respiratory deaths in a resource-limited setting

Drucilla J Roberts, Henry N Njuguna, Barry Fields, Corinne L Fligner, Sherif R Zaki, M Kelly Keating, Emily Rogena, Edwin Walong, Andrew K Gachii, Elizabeth Maleche-Obimbo, Grace Irimu, John Mathaiya, Noelle Orata, Rosemarie Lopokoiyit, Jackson Michuki, Gideon O Emukule, Clayton O Onyango, Stella Gikunju, Collins Owuor, Peter K MuturiMilka Bunei, Marc-Alain Widdowson, Joshua A Mott, Sandra S Chaves

Institute of Tropical Medicine

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Abstract

Objectives: We compared minimally invasive tissue sampling (MITS) with conventional autopsy (CA) in detection of respiratory pathology/pathogens among Kenyan children younger than 5 years who were hospitalized with respiratory disease and died during hospitalization.

Methods: Pulmonary MITS guided by anatomic landmarks was followed by CA. Lung tissues were triaged for histology and molecular testing using TaqMan Array Cards (TACs). MITS and CA results were compared for adequacy and concordance.

Results: Adequate pulmonary tissue was obtained by MITS from 54 (84%) of 64 respiratory deaths. Comparing MITS to CA, full histologic diagnostic concordance was present in 23 (36%) cases and partial concordance in 19 (30%), an overall 66% concordance rate. Pathogen detection using TACs had full concordance in 27 (42%) and partial concordance in 24 (38%) cases investigated, an overall 80% concordance rate.

Conclusions: MITS is a viable alternative to CA in respiratory deaths in resource-limited settings, especially if combined with ancillary tests to optimize diagnostic accuracy.

Original language	English
Journal	American Journal of Clinical Pathology
Volume	152
Issue number	1
Pages (from-to)	36-49
Number of pages	14
ISSN	0002-9173
DOIs	https://doi.org/10.1093/ajcp/aqz016
Publication status	Published - 2019

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Roberts, D. J., Njuguna, H. N., Fields, B., Fligner, C. L., Zaki, S. R., Keating, M. K., Rogena, E., Walong, E., Gachii, A. K., Maleche-Obimbo, E., Irimu, G., Mathaiya, J., Orata, N., Lopokoiyit, R., Michuki, J., Emukule, G. O., Onyango, C. O., Gikunju, S., Owuor, C., ... Chaves, S. S. (2019). Comparison of minimally invasive tissue sampling with conventional autopsy to detect pulmonary pathology among respiratory deaths in a resource-limited setting. American Journal of Clinical Pathology, 152(1), 36-49. https://doi.org/10.1093/ajcp/aqz016

@article{b9e5d675b85a4ebd8acd1342b7a5ec01,

title = "Comparison of minimally invasive tissue sampling with conventional autopsy to detect pulmonary pathology among respiratory deaths in a resource-limited setting",

abstract = "Objectives: We compared minimally invasive tissue sampling (MITS) with conventional autopsy (CA) in detection of respiratory pathology/pathogens among Kenyan children younger than 5 years who were hospitalized with respiratory disease and died during hospitalization.Methods: Pulmonary MITS guided by anatomic landmarks was followed by CA. Lung tissues were triaged for histology and molecular testing using TaqMan Array Cards (TACs). MITS and CA results were compared for adequacy and concordance.Results: Adequate pulmonary tissue was obtained by MITS from 54 (84%) of 64 respiratory deaths. Comparing MITS to CA, full histologic diagnostic concordance was present in 23 (36%) cases and partial concordance in 19 (30%), an overall 66% concordance rate. Pathogen detection using TACs had full concordance in 27 (42%) and partial concordance in 24 (38%) cases investigated, an overall 80% concordance rate.Conclusions: MITS is a viable alternative to CA in respiratory deaths in resource-limited settings, especially if combined with ancillary tests to optimize diagnostic accuracy.",

author = "Roberts, {Drucilla J} and Njuguna, {Henry N} and Barry Fields and Fligner, {Corinne L} and Zaki, {Sherif R} and Keating, {M Kelly} and Emily Rogena and Edwin Walong and Gachii, {Andrew K} and Elizabeth Maleche-Obimbo and Grace Irimu and John Mathaiya and Noelle Orata and Rosemarie Lopokoiyit and Jackson Michuki and Emukule, {Gideon O} and Onyango, {Clayton O} and Stella Gikunju and Collins Owuor and Muturi, {Peter K} and Milka Bunei and Marc-Alain Widdowson and Mott, {Joshua A} and Chaves, {Sandra S}",

year = "2019",

doi = "10.1093/ajcp/aqz016",

language = "English",

volume = "152",

pages = "36--49",

journal = "American Journal of Clinical Pathology",

issn = "0002-9173",

publisher = "Oxford University Press",

number = "1",

}

Roberts, DJ, Njuguna, HN, Fields, B, Fligner, CL, Zaki, SR, Keating, MK, Rogena, E, Walong, E, Gachii, AK, Maleche-Obimbo, E, Irimu, G, Mathaiya, J, Orata, N, Lopokoiyit, R, Michuki, J, Emukule, GO, Onyango, CO, Gikunju, S, Owuor, C, Muturi, PK, Bunei, M, Widdowson, M-A, Mott, JA & Chaves, SS 2019, 'Comparison of minimally invasive tissue sampling with conventional autopsy to detect pulmonary pathology among respiratory deaths in a resource-limited setting', American Journal of Clinical Pathology, vol. 152, no. 1, pp. 36-49. https://doi.org/10.1093/ajcp/aqz016

Comparison of minimally invasive tissue sampling with conventional autopsy to detect pulmonary pathology among respiratory deaths in a resource-limited setting. / Roberts, Drucilla J; Njuguna, Henry N; Fields, Barry et al.
In: American Journal of Clinical Pathology, Vol. 152, No. 1, 2019, p. 36-49.

Research output: Contribution to journal › A1: Web of Science-article › peer-review

TY - JOUR

T1 - Comparison of minimally invasive tissue sampling with conventional autopsy to detect pulmonary pathology among respiratory deaths in a resource-limited setting

AU - Roberts, Drucilla J

AU - Njuguna, Henry N

AU - Fields, Barry

AU - Fligner, Corinne L

AU - Zaki, Sherif R

AU - Keating, M Kelly

AU - Rogena, Emily

AU - Walong, Edwin

AU - Gachii, Andrew K

AU - Maleche-Obimbo, Elizabeth

AU - Irimu, Grace

AU - Mathaiya, John

AU - Orata, Noelle

AU - Lopokoiyit, Rosemarie

AU - Michuki, Jackson

AU - Emukule, Gideon O

AU - Onyango, Clayton O

AU - Gikunju, Stella

AU - Owuor, Collins

AU - Muturi, Peter K

AU - Bunei, Milka

AU - Widdowson, Marc-Alain

AU - Mott, Joshua A

AU - Chaves, Sandra S

PY - 2019

Y1 - 2019

N2 - Objectives: We compared minimally invasive tissue sampling (MITS) with conventional autopsy (CA) in detection of respiratory pathology/pathogens among Kenyan children younger than 5 years who were hospitalized with respiratory disease and died during hospitalization.Methods: Pulmonary MITS guided by anatomic landmarks was followed by CA. Lung tissues were triaged for histology and molecular testing using TaqMan Array Cards (TACs). MITS and CA results were compared for adequacy and concordance.Results: Adequate pulmonary tissue was obtained by MITS from 54 (84%) of 64 respiratory deaths. Comparing MITS to CA, full histologic diagnostic concordance was present in 23 (36%) cases and partial concordance in 19 (30%), an overall 66% concordance rate. Pathogen detection using TACs had full concordance in 27 (42%) and partial concordance in 24 (38%) cases investigated, an overall 80% concordance rate.Conclusions: MITS is a viable alternative to CA in respiratory deaths in resource-limited settings, especially if combined with ancillary tests to optimize diagnostic accuracy.

AB - Objectives: We compared minimally invasive tissue sampling (MITS) with conventional autopsy (CA) in detection of respiratory pathology/pathogens among Kenyan children younger than 5 years who were hospitalized with respiratory disease and died during hospitalization.Methods: Pulmonary MITS guided by anatomic landmarks was followed by CA. Lung tissues were triaged for histology and molecular testing using TaqMan Array Cards (TACs). MITS and CA results were compared for adequacy and concordance.Results: Adequate pulmonary tissue was obtained by MITS from 54 (84%) of 64 respiratory deaths. Comparing MITS to CA, full histologic diagnostic concordance was present in 23 (36%) cases and partial concordance in 19 (30%), an overall 66% concordance rate. Pathogen detection using TACs had full concordance in 27 (42%) and partial concordance in 24 (38%) cases investigated, an overall 80% concordance rate.Conclusions: MITS is a viable alternative to CA in respiratory deaths in resource-limited settings, especially if combined with ancillary tests to optimize diagnostic accuracy.

U2 - 10.1093/ajcp/aqz016

DO - 10.1093/ajcp/aqz016

M3 - A1: Web of Science-article

C2 - 31006817

SN - 0002-9173

VL - 152

SP - 36

EP - 49

JO - American Journal of Clinical Pathology

JF - American Journal of Clinical Pathology

IS - 1

ER -

Comparison of minimally invasive tissue sampling with conventional autopsy to detect pulmonary pathology among respiratory deaths in a resource-limited setting

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