Belew, Adugna (2014) Prevalence of Smear Negative Pulmonary Tuberculosis among PTB Suspected Patients at ADAMA Referral Hospital, ADAMA, Ethiopia. Masters thesis, Addis Ababa University.
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Abstract
BACKGROUND: Tuberculosis is a communicable disease caused by infection with Mycobacterium tuberculosis complex group and infects almost one third part of the world population and kills around two million people worldwide each year. Much attention has recently been paid to the problem of smear-negative pulmonary tuberculosis. Quite appropriately, the discussion has focused on low-income countries, home to the vast majority of individuals with tuberculosis and HIV and where the ability to culture diagnostic specimens may be lacking. In particular, smear-negative pulmonary TB (SNPTB) has become an increasing important clinical and public health problem, especially in areas that are affected by the dual infection of tuberculosis and Human immunodeficiency Virus, such as sub-Saharan Africa including Ethiopia. OBJECTIVE: The aim of the study is to determine the prevalence of smear negative pulmonary tuberculosis using standard culture methods and clinical algorithm among PTB suspected patients at Adama Referral Hospital, Adama, Ethiopia . METHODS: A cross sectional study was conducted among suspected pulmonary tuberculosis patients (age >18 years old) visiting at Adama referral hospital in Eastern oromia Region from June 2013 to December 2013. The study subjects were all smear negative pulmonary tuberculosis patients and a consecutive sampling technique was used. A sputum sample was collected from patients who had smear negative result by Zihel Neelson method/technique. All smear negative pooled sputum samples was processed for culture using conventional Lowenstein-Jensen solid medium at the Adama regional laboratory. Descriptive statistics was computed. P < 0.05 will be statistically significance and multivariate logistic regression will be used for analysis of the result. RESULTS: Of 232 AFB smear-negative patients, 130(56 %) were males. The mean age of the respondents was 40.2 ranging from 19 to 77 years old. Of 232 AFB smear-negative patients, 28 (12.1) were MTB culture positive. Among adults PTB suspected patients; smear-negative TB culture positive was less prevalent (10.7%) in age group 41-50 years. Majority (71.4%) of smear-negative TB culture positive was observed in male. The majority of patients came with a combination of symptoms and the entire patient had chronic cough more than two weeks. Of the study participants, 116(50.0%) had abnormal chest x-ray finding. The binary- logistic regression identified that Productive cough (OR (95%CI)= 0.82(0.81-0.91)), Haemoptysis (OR (95%CI)= 2.43(1.04-5.68)), night sweats (OR (95%CI)= 6.85(2.00-23.39)), Unexplained weight loss (OR (95%CI)= 3.44(1.53-7.72)), the presence of typical X-ray Findings (OR (95%CI)= 2.81(1.18-6.68)), and being HIV patients or positive(OR (95%CI)=4.92(2.1-11.5)) were independently associated with confirmed SNPTB. But in Multivariate regression analysis, Productive cough (OR (95%CI)= 0.82(0.81-0.91)), night sweats (OR (95%CI)= 8.27(2.27-30.1)), and being HIV patients or positive(OR (4.16(1.45-11.96)) were significantly associated with confirmed SNPTB. CONCLUSION: The present study reveals that among smear negative PTB suspects, the prevalence of smear negative culture positive PTB was 12.1%, but 87.6% smear negative pulmonary tuberculosis cases were still etiologically unexplained by culture. Future studies on more affordable, rapid, and accurate tests for TB infection would also be necessary to timely provide specific treatment for patients in need, reduce mortality, and minimize TB transmission to the general population.
| Item Type: | Thesis (Masters) |
|---|---|
| Subjects: | Q Science > Q Science (General) R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine |
| Divisions: | Africana |
| Depositing User: | Vincent Mpoza |
| Date Deposited: | 28 Jun 2018 09:52 |
| Last Modified: | 28 Jun 2018 09:52 |
| URI: | http://thesisbank.jhia.ac.ke/id/eprint/6013 |
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