George Mala1, Mark G Spigt2, Luc G Gidding3, Roman Blanco4, Geert-Jan Dinant5. 1. MSc, Department of Medicine, Mekelle University, Mek'ele, Ethiopia MSc, Department of Family Medicine, Maastricht University/CAPHRI School for Public Health and Primary Care, Maastricht, The Netherlands george.mala@maastrichtuniversity.nl. 2. PhD, Department of Family Medicine, Maastricht University/CAPHRI School for Public Health and Primary Care, Maastricht, The Netherlands PhD, Department of General Practice, Tromsø University, Tromsø, Norway. 3. MD, Department of Family Medicine, Maastricht University/CAPHRI School for Public Health and Primary Care, Maastricht, The Netherlands. 4. MD, Department of Surgery, Universidad de Alcala, Alcala, Spain. 5. MD, PhD, Department of Family Medicine, Maastricht University/CAPHRI School for Public Health and Primary Care, Maastricht, The Netherlands.
Abstract
OBJECTIVES: To determine quality of diagnosis and monitoring of treatment response of patients with smear-negative pulmonary tuberculosis (TB) compared with smear-positive cases in Ethiopia. METHODS: A retrospective analysis of medical records of newly diagnosed pulmonary TB cases that were registered for taking anti-TB medication and had completed treatment between 2010 and 2012. We evaluated the percentage of cases that were managed according to the International Standards of Tuberculosis Care (ISTC) and compared smear-negative with smear-positive cases. RESULTS: We analysed 1168 cases of which 742 (64%) were sputum smear-negative cases. Chest radiography examination at diagnosis and microbiological testing at the end of the intensive phase of treatment was performed in a smaller proportion than in smear-positive TB cases (70% vs. 79%, P value <0.001) and (70% vs. 95%, P value <0.001), respectively. CONCLUSIONS: Clinical actions recommended in the ISTC are of greatest importance in minimising pitfalls in care of smear-negative TB yet were performed less often in smear-negative than smear-positive TB cases.
OBJECTIVES: To determine quality of diagnosis and monitoring of treatment response of patients with smear-negative pulmonary tuberculosis (TB) compared with smear-positive cases in Ethiopia. METHODS: A retrospective analysis of medical records of newly diagnosed pulmonary TB cases that were registered for taking anti-TB medication and had completed treatment between 2010 and 2012. We evaluated the percentage of cases that were managed according to the International Standards of Tuberculosis Care (ISTC) and compared smear-negative with smear-positive cases. RESULTS: We analysed 1168 cases of which 742 (64%) were sputum smear-negative cases. Chest radiography examination at diagnosis and microbiological testing at the end of the intensive phase of treatment was performed in a smaller proportion than in smear-positive TB cases (70% vs. 79%, P value <0.001) and (70% vs. 95%, P value <0.001), respectively. CONCLUSIONS: Clinical actions recommended in the ISTC are of greatest importance in minimising pitfalls in care of smear-negative TB yet were performed less often in smear-negative than smear-positive TB cases.