Case finding for pulmonary tuberculosis, Queen Elizabeth Central Hospital, Blantyre, Malawi
Abstract: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.
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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