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Comparison of Tuberculosis Case-Finding In a High Prevalence Area
Abstract
This comparison of bacteriological methods for tuberculosis case-finding was made on 1 595 specimens from persons in 16 locations in the Transkei. Sputum induced by mechanical stimulation of epiglottis and larynx was superior to cultured laryngeal swabs. The 2-minute examinations by fluorescence microscopy yielded 1,5 times as many positive smears as 4-minute examinations by light microscopy. Culture yielded 97 strains of M. tuberculosis, or 6,6%, and 171 colonies of other mycobacteria. Of the tuberculous sputa 58% had only 20 colonies or less and none of these were recognised to contain tubercle bacilli by microscopy. Of the culturepositive smears 36% had been diagnosed on smear. The potential yield of inoculating only one slope was calculated to be 73% of the positive specimens. For high prevalence areas such as the Transkei a network of facilities for microscopic examination is recommended.
