Quality of diagnosis and monitoring of tuberculosis in Northern Ethiopia: medical records-based retrospective study
Department of Medicine, Mekelle University, Mek’ele, Ethiopia; Department of Family Medicine, Maastricht University/CAPHRI School for Public Health and Primary Care, Maastricht, Netherlands; Department of General Practice, Tromsø University, Tromsø, Norway; Department of Surgery, Universidad de Alcala, Alcala, Spain
Objectives: To determine quality of diagnosis and monitoring of treatment response of patients with smear-negative pulmonary tuberculosis (TB) compared with smear-positive cases in Ethiopia. Methods: A retrospective analysis of medical records of newly diagnosed pulmonary TB cases that were registered for taking anti-TB medication and had completed treatment between 2010 and 2012. We evaluated the percentage of cases that were managed according to the International Standards of Tuberculosis Care (ISTC) and compared smear-negative with smear-positive cases. Results: We analysed 1168 cases of which 742 (64%) were sputum smear-negative cases. Chest radiography examination at diagnosis and microbiological testing at the end of the intensive phase of treatment was performed in a smaller proportion than in smear-positive TB cases (70% vs. 79%, P value 0.001) and (70% vs. 95%, P value 0.001), respectively. Conclusions: Clinical actions recommended in the ISTC are of greatest importance in minimising pitfalls in care of smear-negative TB yet were performed less often in smear-negative than smear-positive TB cases. © 2015, © The Author(s) 2015.
antibiotic agent; adult; aged; antibiotic therapy; Article; controlled study; coughing; diagnostic test; Ethiopia; female; fever; health care personnel; hemoptysis; human; lung tuberculosis; major clinical study; male; medical record; microbiological examination; night sweat; quality control procedures; retrospective study; smear tuberculosis test; sputum smear; thorax radiography