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While it is possible that some misclassification of TB deaths or non-TB deaths occurred, the misclassification bias should have been minimized by the death registration system.
Thirdly, some level of misclassification of TB cases or non-TB migrants might have occurred as intra-observer and inter-observer variations in radiological assessment of TB cases have been reported [ 35, 36].
Finally, we performed multiple sensitivity analyses to be sure that misclassification of TB status did not affect the internal validity of our findings.
Since the majority of patients had EP-TB and sputum smear-negative PTB, there are possibilities of misclassification of TB diagnosis and treatment outcomes.
However, since Delhi is an urban centre with many tertiary care hospitals and as most of the childhood TB patients based on the programmatic observation are diagnosed by pediatricians and referred to the programme for treatment, the extent of misclassification of TB diagnosis, if any, will most likely be insignificant.
However, given that the present study is prospective in nature and patients were followed up for 2 months, misclassification of TB diagnosis should be minimal; this is a strength of the study.
Similar(53)
Such variation in misclassification of cases of TB may also be attributable to the difference in experience and training of the workforce, particularly in small abattoirs where more experienced inspectors are not routinely present to provide supervision and monitoring.
However, there are reports that NTM disease could be underreported in some settings [ 26, 27] and that misclassification of NTM as TB might occur [ 28- 30].
Furthermore, although we know that clinical misclassification of deaths in TB programmes is common [ 16, 20, 21], there is a paucity of studies using autopsy to confirm the cause of death [ 22, 23].
Other causes of TB misclassification such as laboratory cross contamination, PCR contamination or ambiguous hybridization patterns could also be clarified.
Therefore, there may be misclassification of T2D.
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