Journal Article
|ResearchDiagnostic management and outcomes of pulmonary tuberculosis suspects admitted to a central hospital in Malawi
Abstract
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.
RESULT
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.
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.
RESULT
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.
Countries
Subject Area
Languages
English
