Relation of grading of sputum smears with clinical features of tuberculosis patients in routine practice in Sudan.
METHODS
Health services in Khartoum, Red Sea, Gadarif, Kassala, Bahr el Jebel, Gezira and North Kordofan States of Sudan.


OBJECTIVE
To investigate the association of presenting symptoms and clinical history with grade of sputum smear positivity in tuberculosis patients.


METHODS
The 5338 tuberculosis suspects aged 15 to 49 years who consulted between March 1998 and March 1999 underwent sputum smear microscopy, with smears graded by a standardised method. Patients who gave consent had a structured interview concerning the nature and duration of their symptoms and whether they had a sick relative at home. Statistical analysis determined the association of symptoms and home characteristics with the results of smear examination.


RESULTS
A total of 514 suspects (9.6%) demonstrated acid-fast bacilli: 45 (8.8%) grade +1, 167 (32.5%) grade +2 and 302 (58.8%) grade +3. Most of the patients had a duration of symptoms of 6-9 weeks, while 100 had symptoms of more than one year's duration, many (n = 47) with other chronic respiratory diseases. Multiple chest symptoms were positively, and duration of symptoms negatively associated with grade of positivity (P = 0.018 and 0.028, respectively). A high grade of smear positivity (+3) and the longest duration of symptoms, among those reporting symptoms of less than one year's duration, were significant predictors of the presence of a sick household member (OR = 1.99, 95%CI 1.12-3.55; OR = 1.004, 95%CI 1.000-1.008).


CONCLUSIONS
This study demonstrates a relation between the grade of smear positivity and the clinical features of tuberculosis patients.
El-Sony
A
A
National Tuberculosis Programme, Khartoum, Sudan. aelsony@hotmail.com
Enarson
D
D
Khamis
A
A
Baraka
O
O
Bjune
G
G
D017677:Age Distribution; D015331:Cohort Studies; D016001:Confidence Intervals; D005194:Family Practice; D005260:Female; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008854:Microscopy, Electron; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification*; D011336:Probability; D011446:Prospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D017678:Sex Distribution; D013183:Sputum / Q000382:microbiology*; D013397:Sudan / Q000453:epidemiology; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000453:epidemiology