English

Abstract

BACKGROUND: Case detection is based on identification of TB suspects attending health facilities and subjecting them to sputum examination in a RNTCP Designated Microscopy Centre (DMC). Any patient presenting with cough for more than 2 weeks is a pulmonary TB suspect and is to be referred to the DMC. In a peripheral health institution (PHI) of rural setting, it is expected that at least 2% of new adult out patients are chest symptomatic (pulmonary TB suspects). There is paucity of data regarding the prevalence of cough for more than 2 weeks in community. Objective: To determine the prevalence of cough for more than 2 weeks in a rural community. Materials and Methods: This is a cross sectional study conducted among 239 households in Kallara panchayath in Thiruvananthapuram district Kerala. Results: The prevalence of cough for more than 2 weeks was found to 13.8%, with highest prevalence among the age group of 45 to 60 years. Conclusion: Prevalence of cough for more than 2 weeks in the community is high and need more activities to encouraged sputum to be tested to rule out pulmonary tuberculosis. BACKGROUND: As per the World Health Organization (WHO) global TB control report 2011, India continues to bear the highest global burden of TB with an estimated 2.3 million incident cases per annum accounting for more than one-fourth of global TB incidence (1). The cough is the major symptom of pulmonary tuberculosis, subjects with coughs contributed 69.5% (2). Case detection is based on identification of TB suspects attending health facilities and subjecting them to sputum examination in a RNTCP Designated Microscopy Centre (DMC). Any patient presenting with cough for more than 2 weeks is a pulmonary TB suspect and is to be referred to the DMC (3). In a peripheral health institution (PHI) of rural setting, it is expected that at least 2% of new adult out patients are chest symptomatic (pulmonary TB suspects). It is expected that on an average 5-15% of the chest symptomatic subjected for sputum examination are found to be sputum smear positive following standard operating procedures of ZN staining (4). The yield of sputum positive cases is not much changed when more than two weeks of cough and more than three weeks of cough were compared, 9.4-11.1% for 2weeks against 11.3-13.5% for 3weeks (5). Usually these chests symptomatic are identified from patients attending general outpatient departments. If we examine 10 patients with cough of two weeks or more duration, it is supposed to identify one smear positive pulmonary tuberculosis. Based on the annual risk of infection (ARI), it is expected that at least 2 to 4% of the patient attending the general OPDs are chest symptomatic. The load of chest symptomatic in community; is still not clear, because of the varying health seeking behavior and use of alternative systems of medicine in rural areas. This study assesses the prevalence of cough for more than 2 weeks in a rural community, where lot of alternative systems exists for cough management. MATERIALS AND METHOD: This study was conducted in a rural panchayath in Kerala, Kallara which is a field practicing area of Sree Gokulam Medical College. This was a cross sectional survey