[Improved case finding by using sputum examination in pulmonary tuberculosis suspects with clinical symptoms].

OBJECTIVE

To investigate more effective methods in case finding of tuberculosis (TB).

METHODS

Sputum examination for TB suspects was applied on the basis of traditional chest X-ray screening. TB suspects with cough more than 3 weeks were subjected to a sputum examination firstly. The case finding rate of X-ray screening alone and in combination with sputum examination for TB suspects were compared.

RESULTS

Nine hundred new cases of active pulmonary TB were detected by application of sputum examination to TB suspects, among which 73 more cases were found than X-ray screening alone, and the case detection rate increased 8.8% (73/827). Among the 900 new cases, 30 more cases were found than that of X-ray screening alone in 262 smear positive cases, and the case detection rate increased 12.9%. Three hundred sixty cases were culture positive, among which 63 more cases were found than X-ray screening alone, the case detection rate increased 21.2% (63/297). Among the cases detected by X-ray screening alone, the smear positive rate was 28.1% (232/827), and the culture positive rate was 35.9% (297/827). However, among the cases detected by sputum examination, 29.1% (262/900) was smear positive, and 40.0% (360/900) was culture positive. Among the 73 more cases of active pulmonary TB found by using sputum examination in TB suspects, both the smear positive and the culture positive rates were higher, 41.1% (30/70) and 86.3% (63/73) respectively, as compared to those of cases found by X-ray screening (28.1% and 35.9% respectively).

CONCLUSION

Sputum examination in individuals with symptoms suggestive of pulmonary TB could find out more cases with active disease (21.2%) than chest X-ray screening alone.