When are follow-up sputum smears actually examined in patients treated for new smear-positive pulmonary tuberculosis?
METHODS
All 44 non-private hospitals (four central, 22 district and 18 mission) in Malawi that registered and treated tuberculosis (TB) cases, October-December 2001.


OBJECTIVE
To determine, in new smear-positive pulmonary tuberculosis (PTB) patients, for the 2-, 5- and 7-month smear examinations, 1) the proportion with smears examined and 2) the actual timing of smear examination.


METHODS
Retrospective data collection using TB registers, TB treatment cards and laboratory sputum registers. Timing of smear examinations was judged acceptable if 2-month smears were examined at 2 or 3 months, 5-month smears at 4, 5 or 6 months and 7-month smears at 6, 7, 8 or 9 months.


RESULTS
Of 1994 patients, for those alive and on treatment, 78% had smears definitely examined at 2 months, 75% at 5 months and 74% at 7 months. Of these, 82% had smears examined at an acceptable time for the 2-month smear, 71% for the 5-month smear and 78% for the 7-month smear. Smears were examined after the 8-month treatment regimen for the 2- and 5-month smear in respectively 2% and 9% of patients. Smears were done more frequently in female than male patients, and in district/mission hospitals than central hospitals. Smears were done at acceptable times more frequently in younger than older patients and in mission/central hospitals than district hospitals.


CONCLUSIONS
During supervision, the actual time of follow-up sputum smear examinations needs to be monitored more closely.
Harries
A D
AD
National Tuberculosis Control Programme, Community Health Science Unit, Lilongwe, Malawi. adharries@malawi.net
Gausi
F
F
Salaniponi
F M
FM
D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D003266:Continuity of Patient Care; D005260:Female; D006801:Humans; D008295:Malawi; D008297:Male; D012189:Retrospective Studies; D013048:Specimen Handling / Q000379:methods; D013183:Sputum / Q000382:microbiology*; D013997:Time Factors; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology*
D000995:Antitubercular Agents