title: Resources for controlling tuberculosis in Malawi.
abstract: OBJECTIVE
  To document resources for controlling tuberculosis (TB) in Malawi.
  
  
  METHODS
  We performed a countrywide study of all 43 hospitals (3 central, 22 district and 18 mission) which register and treat patients with TB. To collect data for 1998 on the TB-related workload, diagnostic facilities, programme staff and treatment facilities, we used laboratory, radiographic and TB registers, conducted interviews and visited hospital facilities.
  
  
  RESULTS
  The data show that in 1998, 88,257 TB suspects/patients contributed approximately 230,000 sputum specimens for smear microscopy, 55,667 chest X-rays were performed and 23,285 patients were registered for TB treatment. There were 86 trained laboratory personnel, 44 radiographers and 83 TB programme staff. Of these, about 40% had periods of illness during 1998. Approximately 20% of the microscopes and X-ray machines were broken. Some 16% of the hospital beds were designated for TB patients in special wards, but even so, the occupancy of beds in TB wards exceeded 100%. Although stocks of anti-TB drugs were good, there was a shortage of full-time TB ward nurses and 50% of district hospitals conducted no TB ward rounds. In general, there was a shortage of facilities for managing associated HIV-related disease; central hospitals, in particular, were underresourced.
  
  
  CONCLUSIONS
  Malawi needs better planning to utilize its manpower and should consider cross-training hospital personnel. The equipment needs regular maintenance, and more attention should be paid to HIV-related illness. The policies of decentralizing resources to the periphery and increasing diagnostic and case-holding resources for central hospitals should be continued.
authors.affiliation: National Tuberculosis Control Programme, Ministry of Health, PO Box 30377, Capital City, Lilongwe 3, Malawi. adharries@malawi.net
authors.forename: A D
authors.initials: AD
authors.lastname: Harries
authors.forename: J H
authors.initials: JH
authors.lastname: Kwanjana
authors.forename: N J
authors.initials: NJ
authors.lastname: Hargreaves
authors.forename: J
authors.initials: J
authors.lastname: Van Gorkom
authors.forename: F M
authors.initials: FM
authors.lastname: Salaniponi
mesh_terms: D000995:Antitubercular Agents / Q000627:therapeutic use; D003140:Communicable Disease Control / Q000458:organization & administration*; D017281:Cost of Illness; D003625:Data Collection; D006295:Health Resources / Q000458:organization & administration*; D006801:Humans; D008295:Malawi / Q000453:epidemiology; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control*
chemical_list: D000995:Antitubercular Agents