Harries, AD; Hargreaves, NJ; Kwanjana, JH; Salaniponi, FM; (2001) Clinical diagnosis of smear-negative pulmonary tuberculosis: an audit of diagnostic practice in hospitals in Malawi. The international journal of tuberculosis and lung disease, 5 (12). pp. 1143-1147. ISSN 1027-3719 https://researchonline.lshtm.ac.uk/id/eprint/8890
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https://researchonline.lshtm.ac.uk/id/eprint/8890
Abstract
SETTING: Thirty-seven hospitals in Malawi. OBJECTIVE: To audit the hospital practice of clinically diagnosing adults with smear-negative pulmonary tuberculosis (PTB). DESIGN: A cross-sectional survey of adults aged 15 years or above who were registered and receiving inpatient treatment for smear-negative PTB. An assessment of each patient was carried out to determine 1) the number of recommended diagnostic guidelines (cough >3 weeks, no response to antibiotics, negative sputum smears and a chest radiograph compatible with PTB) used by hospital staff in making the diagnosis of PTB, and 2) whether the clinical diagnosis of smear-negative PTB was correct according to criteria set by the study. RESULTS: There were 259 patients, 127 men and 132 women, with a mean age of 37 years; 93% had a cough >3 weeks, 95% had received one or more courses of antibiotics, 92% had submitted sputum samples for smear examination and 97% had chest radiographs performed. In 148 (57%) patients, all four diagnostic guidelines were used, and in 238 (92%) patients three or more were used. The diagnosis of smear-negative PTB was considered correct by study criteria in 203 (78%) patients. In the remainder, 22 (8%) were considered to have extrapulmonary TB and 34 (14%) another diagnosis. CONCLUSION: Hospital practices in the diagnosis of smear-negative PTB are reasonable, although there is room for improvement with in-service training and regular audits of practice.
Item Type | Article |
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Keywords | Adult, Cross-Sectional Studies, Female, Hospitals, Humans, Malawi, Male, Medical Audit, Mycobacterium tuberculosis, Practice Guidelines, Registries, Sputum, Tuberculosis, Pulmonary, Adult, Cross-Sectional Studies, Female, Hospitals, Humans, Malawi, epidemiology, Male, Medical Audit, Mycobacterium tuberculosis, isolation & purification, Practice Guidelines, Registries, Sputum, microbiology, Tuberculosis, Pulmonary, diagnosis, epidemiology |
Faculty and Department | Faculty of Infectious and Tropical Diseases > Dept of Clinical Research |
PubMed ID | 11769773 |
ISI | 172895900011 |