Sputum smear examination and time to diagnosis in patients with smear-negative pulmonary tuberculosis in the Pacific
OBJECTIVE: To determine the proportion of all tuberculosis (TB) cases that were pulmonary smear-negative, and for these patients to determine how many sputum smears were examined and the time from sputum smear examination to registration.
DESIGN: A retrospective cross-sectional study involving a record review of national TB and laboratory registers.
RESULTS: Of 2420 TB cases identified, 709 (29%) were registered as smear-negative pulmonary TB. Of the 695 (98%) with information on smear examination, 222 (32%) had no smear recorded, 61 (9%) had one smear, 86 (12%) two smears and 326 (47%) three smears. Among the 473 patients who had at least one smear, 238 (50%) were registered before sputum examination, 131 (28%) within 1 week, 72 (15%) between 1 and 4 weeks, and 34 (7%) >4 weeks after sputum examination.
CONCLUSION: NTPs in Kiribati and the Marshall Islands are diagnosing 29% of all TB patients as smear-negative pulmonary TB. Many patients do not have smears done or are registered before undergoing smear examination. Corrective measures are needed.
Keywords: Pacific; operational research; pulmonary tuberculosis; smear-negative
Document Type: Research Article
Affiliations: 1: Secretariat of the Pacific Community, Noumea, New Caledonia 2: International Union Against Tuberculosis and Lung Disease, Paris, France; and The University of Auckland, Auckland, New Zealand 3: Ministry of Health and Medical Services, Tarawa, Republic of Kiribati 4: World Health Organization, Geneva, Switzerland 5: Ministry of Health, Majuro, Republic of Marshall Islands 6: International Union Against Tuberculosis and Lung Disease, Paris, France; and London School of Hygiene & Tropical Medicine, London, United Kingdom
Publication date: 21 December 2012
Public Health Action (PHA), The Union's quarterly Open Access journal, welcomes the submission of articles on operational research. It publishes high-quality scientific research on health services, providing new knowledge on how to improve access, equity, quality and efficiency of health systems and services.
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