Public health action · 2011
Diagnostic management and outcomes of pulmonary tuberculosis suspects admitted to a central hospital in Malawi.
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Gawa L G, Reid T, Edginton M E, Van Lettow M, Joshua M, Harries A D
Аннотация
SETTING: Zomba Central Hospital, Malawi.
OBJECTIVE: To determine diagnostic management and outcomes of pulmonary tuberculosis (PTB) suspects admitted to adult wards.
DESIGN: A retrospective, cross-sectional review of medical records of patients admitted to hospital between July and September 2010.
RESULTS: There were 141 PTB suspects. Sputum examination was requested and performed in 67 (48%) suspects, but none were smear-positive. Chest X-ray (CXR) was requested and performed in 26 (39%) suspects whose sputum smears were negative. Eleven suspects had a CXR suggestive of PTB: two were started on TB treatment and eight died before treatment started. Human immunodeficiency virus (HIV) status was known for 50 patients (35% of all suspects) on admission, all of whom were HIV-positive. HIV testing was requested for 37 patients, but was only performed in 12, five of whom were HIV-positive. Only one patient was referred for antiretroviral treatment. There were 41 (29%) deaths, eight of whom had probable TB and were not treated. In the remaining 33 patients who died, only nine (27%) had sputum smears examined and four (12%) had a CXR.
CONCLUSION: The study shows inadequacies in the diagnostic management of PTB suspects in the Zomba Central Hospital, but suggests opportunities for improvement.
OBJECTIVE: To determine diagnostic management and outcomes of pulmonary tuberculosis (PTB) suspects admitted to adult wards.
DESIGN: A retrospective, cross-sectional review of medical records of patients admitted to hospital between July and September 2010.
RESULTS: There were 141 PTB suspects. Sputum examination was requested and performed in 67 (48%) suspects, but none were smear-positive. Chest X-ray (CXR) was requested and performed in 26 (39%) suspects whose sputum smears were negative. Eleven suspects had a CXR suggestive of PTB: two were started on TB treatment and eight died before treatment started. Human immunodeficiency virus (HIV) status was known for 50 patients (35% of all suspects) on admission, all of whom were HIV-positive. HIV testing was requested for 37 patients, but was only performed in 12, five of whom were HIV-positive. Only one patient was referred for antiretroviral treatment. There were 41 (29%) deaths, eight of whom had probable TB and were not treated. In the remaining 33 patients who died, only nine (27%) had sputum smears examined and four (12%) had a CXR.
CONCLUSION: The study shows inadequacies in the diagnostic management of PTB suspects in the Zomba Central Hospital, but suggests opportunities for improvement.