Management of pulmonary tuberculosis suspects with negative sputum smears and normal or minimally abnormal chest radiographs in resource-poor settings.
Int J Tuberc Lung Dis
; 2(12): 999-1004, 1998 Dec.
Article
de En
| MEDLINE
| ID: mdl-9869116
ABSTRACT
SETTING:
Queen Elizabeth Central Hospital, Blantyre, Malawi.OBJECTIVES:
1) To determine the proportion of pulmonary tuberculosis (PTB) suspects with negative sputum smears and a normal/minimally abnormal chest radiograph (CXR) who are culture-positive for Mycobacterium tuberculosis, and 2) to determine how many develop smear or radiographic evidence of PTB (TB CXR) during follow-up.METHODS:
PTB suspects with negative sputum smears and a normal/minimally abnormal CXR were given a second course of antibiotics and followed up at 3-week intervals over 3 months with repeat sputum smears and chest radiography.RESULTS:
Of 79 patients (38 men and 41 women, mean age 33 years) with negative smears and a normal/minimally abnormal CXR, 16 (21%) were culture-positive for M. tuberculosis. Of 15 culture-positive patients who were alive and attended follow-up, seven (47%) developed a TB-CXR by 3 months. Of 41 culture-negative patients who were alive and attended follow-up, 13 (32%) developed a TB-CXR, including one patient who became sputum smear-positive. TB-CXRs were found only in patients with a cough.CONCLUSION:
TB suspects with negative smears and normal/minimally abnormal CXRs in high human immunodeficiency virus (HIV) prevalent countries should be given a second course of antibiotics. If cough improves, patients can be advised not to return for further follow-up. If cough continues, patients should return for further follow-up with sputum smear examination and chest radiography. Approximately 50% of those who have culture-positive PTB will develop a TB-CXR by 3 months and can be identified if radiographic facilities are available.
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Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Tuberculose pulmonaire
/
Pays en voie de développement
Type d'étude:
Diagnostic_studies
/
Prognostic_studies
Aspects:
Determinantes_sociais_saude
Limites:
Adult
/
Female
/
Humans
/
Male
Pays/Région comme sujet:
Africa
Langue:
En
Journal:
Int J Tuberc Lung Dis
Année:
1998
Type de document:
Article
Pays d'affiliation:
Malawi