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Free Content Relation of grading of sputum smears with clinical features of tuberculosis patients in routine practice in Sudan

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SETTING: Health services in Khartoum, Red Sea, Gadarif, Kassala, Bahr el Jebel, Gezira and North Kordofan States of Sudan.

OBJECTIVE: To investigate the association of presenting symptoms and clinical history with grade of sputum smear positivity in tuberculosis patients.

METHODS: The 5338 tuberculosis suspects aged 15 to 49 years who consulted between March 1998 and March 1999 underwent sputum smear microscopy, with smears graded by a standardised method. Patients who gave consent had a structured interview concerning the nature and duration of their symptoms and whether they had a sick relative at home. Statistical analysis determined the association of symptoms and home characteristics with the results of smear examination.

RESULTS: A total of 514 suspects (9.6%) demonstrated acid-fast bacilli: 45 (8.8%) grade +1, 167 (32.5%) grade +2 and 302 (58.8%) grade +3. Most of the patients had a duration of symptoms of 6–9 weeks, while 100 had symptoms of more than one year's duration, many (n = 47) with other chronic respiratory diseases. Multiple chest symptoms were positively, and duration of symptoms negatively associated with grade of positivity (P = 0.018 and 0.028, respectively). A high grade of smear positivity (+3) and the longest duration of symptoms, among those reporting symptoms of less than one year's duration, were significant predictors of the presence of a sick household member (OR = 1.99, 95%CI 1.12–3.55; OR = 1.004, 95%CI 1.000–1.008).

CONCLUSION: This study demonstrates a relation between the grade of smear positivity and the clinical features of tuberculosis patients.
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Keywords: Sudan; diagnosis; direct microscopy; infection; tuberculosis

Document Type: Regular Paper

Affiliations: 1: National Tuberculosis Programme, Khartoum, Sudan 2: International Union Against Tuberculosis and Lung Disease, Paris, France 3: Department of Medicine, Ahfad University for Women, and School of Mathematics, Bayan College for Science and Technology, Khartoum, Sudan 4: Department of Medicine, University of Khartoum, Khartoum, Sudan 5: Department of International Health, Faculty of Medicine, University of Oslo, Oslo, Norway

Publication date: February 1, 2002

More about this publication?
  • 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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