Comparison of cough of 2 and 3 weeks to improve detection of smear-positive tuberculosis cases among out-patients in India
Authors: Santha, T.1; Garg, R.2; Subramani, R.1; Chandrasekaran, V.1; Selvakumar, N.1; Sisodia, R. S.3; Perumal, M.4; Sinha, S. K.5; Singh, R. J.3; Chavan, R.6; Ali, F.7; Sarma, S. K.3; Sharma, K. M.8; Jagtap, D.6; Frieden, T. R.2; Fabio, L.9; Narayanan, P. R.1
Source: The International Journal of Tuberculosis and Lung Disease, Volume 9, Number 1, January 2005 , pp. 61-68(8)
Abstract:SETTING: Governmental health facilities in six districts of India.
OBJECTIVE: To estimate the prevalence of cough and to compare the detection of smear-positive tuberculosis (TB) among out-patients with cough of ≥2 or ≥3 weeks.
DESIGN: Trained health workers questioned each out-patient for presence of cough. Those with cough ≥2 weeks underwent sputum microscopy.
RESULTS: Of 55561 out-patients interviewed, 2210 (4%) had cough ≥2 weeks, of whom 267 had sputum-positive TB, compared to 182/1370 with cough ≥3 weeks. The 31% who did not spontaneously complain of cough were less likely to be sputum-positive than those who did (45/680 [7%] vs. 222/1530 [15%], P < 0.001), but they accounted for 45/267 smear-positive cases. Using cough ≥2 weeks as the screening criterion, the estimated number of smears performed per day at each primary and secondary health care facility was respectively 8 and 19, compared to 5 and 12 using cough ≥3 weeks.
CONCLUSION: The detection of smear-positive TB cases can be substantially improved by actively eliciting history of cough from all out-patients, and by changing the screening criterion for performing sputum microscopy among out-patients from cough ≥3 weeks to ≥2 weeks. Before implementing this change nationally, its programmatic feasibility should be assessed.
Document Type: Regular Paper
Affiliations: 1: Tuberculosis Research Center, Chennai, India 2: World Health Organization, Delhi, India 3: RNTCP, Jaipur, Rajasthan, India 4: RNTCP, Chennai, Tamil Nadu, India 5: RNTCP, Udaipur, Rajasthan, India; and RNTCP, Pali, Rajasthan, India 6: RNTCP, Pune, Maharashtra, India 7: RNTCP, Pali, Rajasthan, India 8: RNTCP, Udaipur, Rajasthan, India 9: World Health Organization, Geneva, Switzerland
Publication date: January 1, 2005
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- By this author: Santha, T. ; Garg, R. ; Subramani, R. ; Chandrasekaran, V. ; Selvakumar, N. ; Sisodia, R. S. ; Perumal, M. ; Sinha, S. K. ; Singh, R. J. ; Chavan, R. ; Ali, F. ; Sarma, S. K. ; Sharma, K. M. ; Jagtap, D. ; Frieden, T. R. ; Fabio, L. ; Narayanan, P. R.