Tuberculosis in health care workers in a central hospital in Malawi.

A retrospective study was carried out at Lilongwe Central Hospital, Malawi, to determine 1) the tuberculosis case notification rate in health care workers (HCW) in 2001, and 2) whether NTP guidelines were adhered to in diagnosing TB. Of 571 HCWs, 33 (6%) were notified with TB in 2001, giving a TB case notification rate of 5780/100,000. Patient attendants had higher rates of TB than nurses, ward attendants and doctors, but otherwise there were no significant differences between the HCW categories. NTP diagnostic guidelines were not properly followed, particularly in diagnosing smear-negative TB; in HCWs with smear-negative PTB, 64% had no sputum smears examined. The rate of TB in HCWs in a central hospital in Malawi was high, although lack of adherence to guidelines might have resulted in overdiagnosis.