Bronchopulmonary Tuberculosis- Laboratory Diagnosis And Dots Strategy Outcome In A Rural Community: A Retrospective Study

Abstract

Pulmonary tuberculosis is still a global public health threat. Despite all efforts at its containment, the scourge is still menacing especially in the rural communities and among HIV infected patients. This retrospective study was carried out to determine the case detection rate of pulmonary tuberculosis in a rural community hospital in Nigeria from 2001-2006. A total of 1219 suspected patients were tested for pulmonary tuberculosis by sputum smear stained by Ziehl-Neelsen technique. Out of this number, 350 (28.7%) were positive for Acid-Fast Bacilli including 198 males and 152 females. Also 235 of the sputum-smear positive patients were tested for the human immunodeficiency virus (HIV) antibodies by Immunocomb 11 HIV 1 & 2 Bispot and confirmed by Immunocomb 11 HIV 1 & 2 Combfirm and HIV-1 Western Blot kit. Sixty three (26.8%) of the sputum-smear positive patients were co-infected with HIV. Two hundred and seventy (77.1%) of the AFB positive patients were treated under the Directly Observed Therapy-Short course, 201 of them (74.4%) completed the treatment, 39 (14.4%) defaulted, 30 (11.1%) died before the completion of the treatment, 195 of the patients were declared cured and 6 were declared failed. Case detection rates could be improved upon by providing culture facilities at the DOTS centers. Also efforts should be made to ensure that all positive cases are followed to a logical conclusion and that anti-retroviral drugs are provided for patients co-infected with HIV to reduce the mortality rate of pulmonary tuberculosis.