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Free Content Case finding for pulmonary tuberculosis, Queen Elizabeth Central Hospital, Blantyre, Malawi

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SETTING: Queen Elizabeth Central Hospital, Malawi.

OBJECTIVE: To evaluate the investigation of patients with cough who attend out-patient services and the adherence to recommended diagnostic protocols.

DESIGN: Two operational studies in 1995: 1) an audit of management of patients presenting to non-fee-paying out-patient services (OPD) with cough, and 2) an audit of the laboratory sputum register and the OPD cough register. The annual number of out-patient attendances was also recorded.

RESULTS: Of 2381 patients seen by OPD medical assistants, 438 (18.4%) complained of cough: 303 for <3 weeks and 135 for ≥3 weeks. Sputum smear examinations were requested in 97 patients, 79 (58.5%) with long duration and 18 (5.9%) with short duration of cough. Between May and December 1995, of the 1668 OPD patients who had sputum results in the laboratory register, 1392 (83%) had sputum results in the cough register. Of patients listed in the cough register, 98% collected their sputum smear results. In 1995, there were 395439 OPD attendances; data extrapolation suggests that about 15000 patients should have had sputum examined instead of the 2337 listed in the laboratory register.

CONCLUSION: A large burden is imposed on out-patient services by patients with cough. Despite recommended protocols, this investigation suggests deficiencies in case detection which require further study.

Keywords: Africa; case finding; pulmonary tuberculosis

Document Type: Regular Paper

Affiliations: 1: Department of Medicine, College of Medicine, Blantyre, Malawi 2: Out-Patient Department, Queen Elizabeth Central Hospital, Blantyre, Malawi 3: Global Tuberculosis Programme, World Health Organization, Geneva, Switzerland 4: National Tuberculosis Programme, Ministry of Health, Lilongwe, Malawi

Publication date: 1997-12-01

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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