Prevalence of Smear Negative Pulmonary Tuberculosis Among Ptb Suspected Patients at Adama Referral Hospital, Adama, Ethiopia
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Date
2014-05
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Addis Ababa University
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.
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Keywords
Negative Pulmonary Tuberculosis