Comparison of cough of 2 and 3 weeks to improve detection of smear-positive tuberculosis cases among out-patients in India

Santha, T and Garg, R and Subramani, R and Chandrasekaran, V and Selvakumar, N and Sisodia, R S and Perumal, M and Sinha, S K and Singh, R J and Chavan, R and Ali, F and Sarma, S K and Sharma, K M and Jagtap, D and Frieden, T R and Fabio, L and Narayanan, P R (2005) Comparison of cough of 2 and 3 weeks to improve detection of smear-positive tuberculosis cases among out-patients in India. International Journal of Tuberculosis and Lung Disease, 9 (1). pp. 61-68. ISSN Print: 1027-3719; Online: 1815-7920

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Abstract

SETTING: Governmental health facilities in six districts of India. OBJECTIVE: To estimate the prevalence of cough and to compare the detection of smear-positive tuberculosis (TB) among out-patients with cough of >2 or >3 weeks. DESIGN: Trained health workers questioned each outpatient for presence of cough. Those with cough >2 weeks underwent sputum microscopy. RESULTS: Of 55 561 out-patients interviewed, 2210 (4%) had cough >2 weeks, of whom 267 had sputumpositive TB, compared to 182/1370 with cough >3 weeks. The 31% who did not spontaneously complain of cough were less likely to be sputum-positive than those who did (45/680 [7%] vs. 222/1530 [15%], P , 0.001), but they accounted for 45/267 smear-positive cases. Using cough >2 weeks as the screening criterion, the estimated number of smears performed per day at each primary and secondary health care facility was respectively 8 and 19, compared to 5 and 12 using cough >3 weeks. CONCLUSION: The detection of smear-positive TB cases can be substantially improved by actively eliciting history of cough from all out-patients, and by changing the screening criterion for performing sputum microscopy among out-patients from cough >3 weeks to >2 weeks. Before implementing this change nationally, its programmatic feasibility should be assessed.

Item Type:	Article
Uncontrolled Keywords:	smear-positive tuberculosis; government health facilities; chest symptoms; cough duration
Subjects:	Tuberculosis > Clinical Research
Divisions:	Clinical Research
Depositing User:	Dr. Rathinasabapati R
Date Deposited:	28 Nov 2013 10:28
Last Modified:	09 Mar 2016 08:48
URI:	http://eprints.nirt.res.in/id/eprint/717

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