Tanzania Journal of Health Research
Health User's Trust Fund (HRUTF)
Vol. 14, No. 2, 2012, pp. 1-9
Bioline Code: th12018
Full paper language: English
Document type: Research Article
Document available free of charge
Tanzania Journal of Health Research, Vol. 14, No. 2, 2012, pp. 1-9
© Copyright 2012 - Tanzania Journal of Health Research
Low sputum smear positive tuberculosis among pulmonary tuberculosis suspects in a tertiary hospital in Mwanza, Tanzania|
SENI, JEREMIAH; KIDENYA, BENSON R.; OBASSY, EMMANUEL; MIRAMBO, MARIAM; BURUSHI, VENANCE; MAZIGO, HUMPHREY D.; KAPESA, ANTONY; MAJIGO, MTEBE & MSHANA, STEPHEN E.
Early diagnosis of tuberculosis (TB) and prompt initiation of treatment are essential for
an effective tuberculosis control programme. In many resource limited settings microscopic
diagnosis is still the pivotal tool in the diagnosis of pulmonary TB. This study aimed at
evaluating laboratory microscopic diagnosis of tuberculosis in a tertiary hospital in Mwanza,
Tanzania. This retrospective hospital based study reviewed consecutively from TB registry and
patients’ files a total of 5,922 TB suspects who submitted their sputum for examination between
January 2007 and May 2010 at Bugando Medical Centre (BMC). Among TB suspects (mean
age=36.1±13.6 years) female accounted for 54.1% of the patients. The prevalence of HIV among TB
patients was 59.4%. The sputum smear positivity rate among the TB suspects was 6.1%; the rate
was higher in HIV positive than in HIV negative patients (9.9 % versus 3.2%, P-value < 0.001).
The overall positivity rate for the first smear was 94.2% with an incremental percentage yield of
5.2% and 0.6% for the second and third smears, respectively. The study found that 28.6% of
patients who were positive in the first smear did not return for the second smear. The risk factors
among smear positive TB patients were co-illness (32.5%), previous history of TB (7.5%) and
history of positive TB contact (4.7%). These findings also show that as CD4+ T Cells count
increases, the quantity AFB in sputum smear also increase although not statistically significant.
The sputum smear positivity rate at Bugando Medical Centre is low and more than a quarter of
initial TB suspects who were positive in the first smear were lost to follow up posing a threat of
continuous transmission of tuberculosis to the community. The finding of more sputum smear
positivity rate among HIV positive than HIV negative patients at BMC requires a prospective
study to ascertain whether it is a reality or a coincidence.
Sputum smears; tuberculosis; HIV; Tanzania