| ORIGINAL ARTICLE |
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| Year : 2012 | Volume
: 15
| Issue : 4 | Page : 430-435 |
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Comparative analysis of case screening with varying cough duration and sputum samples for diagnosis of tuberculosis in patients attending the OPD at a tertiary care hospital at Srinagar, India
S Hamid1, SA Hussain2, I Ali1
1 Department of Community Medicine, SKIMS Srinagar, India
2 Department of Internal Medicine, DH Pulwama, A Multispeciality Hospital, Jammu and Kashmir, India
Correspondence Address:
S A Hussain
B Grade consultant, (Tropical medical medical unit), DH Pulwama, Jammu and Kashmir
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/1119-3077.104519
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Research Question: Can we minimize cough duration and number of sputum samples in chest symptomatic patients for screening of TB?
Objective: To evaluate cough of 3 weeks versus 2 weeks duration using two sputum samples versus three samples in chest symptomatic patients attending the OPD.
Study Design: Hospital-based cross-sectional study.
Materials and Methods: Outpatients (2810) with H/O cough of 3 weeks and 2 weeks duration were screened by subjecting them to sputum microscopy for tuberculosis using two sputum samples as well as three samples following standard procedure for sputum collection, staining and acid-fast bacillus (AFB) identification. Those on drugs were not included.
Results: Using ≥2 weeks cough, sputum positivity rate was 12%, nearly as high as the sputum positivity among patients with ≥3 weeks cough, i.e. 14%. First sputum smear alone on an average could detect 91.8% cases, while the first two sputum smears could detect on an average 96% cases. The study showed that maximum number of cases was diagnosed by only two sputum smears and added diagnostic value of third specimen was small, i.e. 4%.High sputum positivity rate using ≥2 weeks cough with two sputum samples was seen.
Conclusion: The sensitivity analysis of the study showed that using ≥2 weeks cough with two sputum samples gives almost similar values as ≥3 weeks cough with three sputum samples, but this needs further confirmatory results of culture sensitivity. Hence, using ≥2 weeks cough with two sputum samples as the diagnostic criteria for screening of cough patients for TB should be recommended as one way of improving efficient use of scarce resources. |
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