Ngadaya Esther S, Mfinanga Godfrey S, Wandwalo Eliud R, Morkve Odd
Centre for International Health, University of Bergen, Bergen, Norway.
BMC Public Health. 2009 Aug 3;9:278. doi: 10.1186/1471-2458-9-278.
Tuberculosis (TB) case detection in women has remained low in developing world. This study was conducted to determine the proportion of smear positive TB among women with cough regardless of the duration attending family Planning (FP) and Maternal and child health (MCH) clinics in Dar es Salaam.
We conducted a cross sectional study in all three municipal hospitals of Dar es Salaam, between October 2007 and June 2008. All women with cough attending FP and MCH clinics were screened for TB by smear microscopy. Pearson chi-square was used to compare group difference for categorical variables. Risk factors for smear positive were estimated by logistics regression with 95% confidence intervals (CI) given for odds ratios indicating statistically significant relationship if the CI did not include one.
We enrolled a total of 749 TB suspects. Five hundred and twenty nine patients (70.6%) were from MCH clinics. Mean (SD) age was 27.6 (5.2) years. A total of 616 (82.2%) patients were coughing for less than two weeks as compared to 133 (17.8%), who coughed for two or more weeks. Among 616 TB suspects, 14 (2.3%) were smear positive TB patients, and of the 133 who had coughed for two or more weeks, 13 (9.8%) were smear positive TB patients. Risk factors associated with smear positive results were having attended more than one visit to any facility prior to diagnosis (OR = 6.8; 95%CI 2.57-18.0) and having HIV/AIDS (OR = 4.4; 95%CI 1.65-11.96). Long duration of cough was not a risk factor for being smear positive (OR = 1.6; 95%CI 0.59-4.49).
The proportion of smear positive TB patients among women with cough attending MCH and FP was 3.8%. Visits to any health facility prior to Diagnosis and HIV infection were risk for having a smear positive TB.
在发展中国家，女性结核病病例的检出率一直较低。本研究旨在确定在达累斯萨拉姆，前往计划生育（FP）和妇幼保健（MCH）诊所就诊的咳嗽女性中涂片阳性结核病的比例，无论其就诊时长如何。
2007年10月至2008年6月期间，我们在达累斯萨拉姆的所有三家市立医院开展了一项横断面研究。所有前往FP和MCH诊所就诊的咳嗽女性均通过涂片显微镜检查筛查结核病。采用Pearson卡方检验比较分类变量的组间差异。通过逻辑回归估计涂片阳性的危险因素，并给出比值比的95%置信区间（CI），若CI不包含1，则表明存在统计学显著关系。
我们共纳入了749名结核病疑似患者。其中529名患者（70.6%）来自MCH诊所。平均（标准差）年龄为27.6（5.2）岁。共有616名（82.2%）患者咳嗽时间少于两周，133名（17.8%）患者咳嗽时间为两周或更长时间。在616名结核病疑似患者中，14名（2.3%）为涂片阳性结核病患者，在133名咳嗽两周或更长时间的患者中，13名（9.8%）为涂片阳性结核病患者。与涂片阳性结果相关的危险因素包括在诊断前曾多次前往任何机构就诊（比值比=6.8；95%CI 2.57-18.0）以及感染艾滋病毒/艾滋病（比值比=4.4；95%CI 1.65-11.96）。咳嗽时间长并非涂片阳性的危险因素（比值比=1.6；95%CI 0.59-4.49）。
在前往MCH和FP诊所就诊的咳嗽女性中，涂片阳性结核病患者的比例为3.8%。诊断前前往任何医疗机构就诊以及感染艾滋病毒是涂片阳性结核病的危险因素。
