29 Nov Diagnosing tuberculosis in Mozambique

Making a diagnosis of tuberculosis in a resource-constrained setting is challenging, especially in a population with a marked prevalence of HIV. WHO issued guidelines to help health staff to systematically assess tuberculosis in patients presenting with cough. The manuscript describes how these guidelines work in everyday life in a large teaching hospital in Mozambique. The initial step of the WHO guidelines (assess danger signs) was not performed in any of the 500+ patients. The most basic test for tuberculosis (examination of sputum) was performed in just 25% of the patients. Instead, chest X-rays were used for diagnosing tuberculosis. Overall a large number of patients remained undetected maintaining active transmission.

Although new diagnostic procedures are being developed, it seems more prudent to implement the procedures that are known to be cost-effective for TB diagnosis

TB diagnostic process management of patients in a referral hospital in Mozambique in comparison with the 2007 WHO recommendations for the diagnosis of smear-negative pulmonary TB and extrapulmonary TB.
Authored by: Bos J. C., Smalbraak L., Macome A.C., Gomes E., van Leth Frank, Prins J. M.
in: International Health, 2013
http://inthealth.oxfordjournals.org/content/early/2013/10/14/inthealth.iht025.abstract
http://www.ncbi.nlm.nih.gov/pubmed/24130098