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Free Content District sputum smear microscopy services in Malawi

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SETTING: Government hospitals and health centres in 23 districts in Malawi.

OBJECTIVE: To determine 1) the number and smear-positivity rate of sputum samples submitted at health centres and hospitals, and 2) the time for sputum samples to get from health centres to smear examination.

DESIGN: Prospective data collection on sputum specimens coming from health centres to hospital laboratories, and over the equivalent time period, retrospective data collection from laboratory sputum registers.

RESULTS: Information was collected over a period of 5.6 months during 1997. Of 21527 patients submitting sputum samples, 16995 (79%) were from within the hospital and 4532 (21%) were from health centres. Of 15833 new TB suspects, 12804 (81%) submitted sputum within the hospital and 3029 (19%) were from health centres. The overall smear-positivity rate was 11.9%: the proportion of new suspects who were smear-positive was significantly higher in health centres (14.1%) compared with hospital-based patients (11.4%, P < 0.05); 27% of all sputum specimens from health centres took 8 days or longer to get to smear examination. Sputum smears were positive from 1–30 days between submission and laboratory examination.

CONCULSION: Fewer sputum samples are submitted at health centres compared with hospitals, and there may be long delays between sputum submission and smear examination. The precise reasons are unclear, but health centre staff need training about the importance of timely case finding procedures.
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Keywords: case finding; health centres; sputum smears

Document Type: Regular Paper

Affiliations: 1: National Tuberculosis Control Programme, Community Health Science Unit, Lilongwe, Malawi 2: Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, UK

Publication date: 1998-11-01

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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.

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