Detection of pulmonary tuberculosis among patients with cough attending outpatient departments in Dar Es Salaam, Tanzania: does duration of cough matter?

Godfrey S Mfinanga,Esther S Ngadaya,Eliud R Wandwalo,Odd Morkve

doi:10.1186/1472-6963-9-112

Abstract

BackgroundAccording to WHO estimates, tuberculosis case detection rate in Tanzania is less than 50% and this poses a major challenge to control tuberculosis in the country. Currently, one of the defining criteria for suspecting tuberculosis is cough for two weeks or more. We wanted to find out whether the prevalence of tuberculosis was different in patients who reported cough for two weeks or more, compared to patients with cough for less than two weeks.MethodsWe conducted a cross sectional study in six health facilities in Dar es Salaam, between September and October 2007. All patients aged five years and above with cough were screened for pulmonary tuberculosis (PTB) by smear microscopy. Patients were divided into two groups, those who coughed for less than two weeks (<2 wks) and those who coughed for two weeks or more (≥ 2 wks).ResultsA total of 65,530 patients attended outpatients department (OPD). Out of these, 2274 (3.5%) patients reported cough. Among patients who reported cough, 2214 (97.4%) remembered their cough duration. One thousand nine hundred and seventy three patients (89.1%) coughed for ≥ 2 wks as compared to 241 (10.9%) patients who coughed for <2 wks. Of those who coughed for two weeks or more, 250 (12.7%) had smear positive PTB, and of those who had coughed for less than two weeks, 21 (8.7%) had smear positive PTB. There was no statistically significant difference in prevalence of smear positive tuberculosis among the two groups (Pearson Chi-Square 3.2; p = 0.074).ConclusionDetection of smear positive PTB among patients who coughed for less than two weeks was as high as for those who coughed for two weeks or more.

Highlights

According to WHO estimates, tuberculosis case detection rate in Tanzania is less than 50% and this poses a major challenge to control tuberculosis in the country
While good TB treatment success rates has been achieved using directly observed short course therapy (DOTS), low case detection rates remain an obstacle to the long-term success of TB control programs in the developing world [3,4]
Setting We conducted the study in six health facilities in Dar es Salaam, which contain a quarter of all TB cases notified in the country [9]

Summary

Introduction

According to WHO estimates, tuberculosis case detection rate in Tanzania is less than 50% and this poses a major challenge to control tuberculosis in the country. We wanted to find out whether the prevalence of tuberculosis was different in patients who reported cough for two weeks or more, compared to patients with cough for less than two weeks. It is more than a decade since tuberculosis (TB) was a global emergency disease, with a call for stronger international effort to fight it. Case detection is still low, in the developing world, where this poses a major challenge [1]. The clinicians registered all patients with cough in a study register and requested the patients to submit three sputum samples as per national guidelines. Study registers contained information on patients' socio-demographic characteristics, cough duration in days or weeks and sputum results

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Conclusion