Eliso Endale, Medhin Girmay, Belay Mulugeta
Shashogo Woreda Health Office, Hadiya Zone, Hosanna, Ethiopia.
Aklilu Lemma Institute of Pathobiology, Addis Ababa University, P.O. Box 1176, Addis Ababa, Ethiopia.
BMC Public Health. 2015 Feb 10;15:112. doi: 10.1186/s12889-015-1411-4.
Excluding patients with cough less than two weeks from screening for TB which is the current practice of TB control program in Ethiopia may result in delayed diagnosis thereby increasing transmission risk to others. The current study aimed to determine the prevalence of smear positive pulmonary tuberculosis among patients presenting with cough to four health centers in Shashogo woreda, Southern Ethiopia.
A cross sectional study was conducted in four health centers in Shashogo Woreda, between November 2011 and March 2012. Four-hundred and sixty one patients aged five years and above attending the outpatient clinics and reporting cough of any duration were screened for pulmonary TB using smear microscopy. During data analysis, patients were classified by duration of cough with the cut-off of two weeks. Stata version 11 was used for data analysis.
A total of 299 patients with cough of two or more weeks and 162 patients with cough less than 2 weeks were recruited. The overall prevalence of smear positive pulmonary TB was 4.6% (95% CI: 2.6% to 7.7%). The prevalence of smear positive pulmonary TB among patients with cough lasting two or more weeks was significantly higher compared to those patients with cough lasting less than two weeks (6.0% versus 1.9%; p = 0.04).
Although the prevalence of smear positive pulmonary TB among patients with cough less than 2 weeks was low, considering the contribution of delayed diagnosis for continued transmission of TB, screening patients with cough less than 2 weeks might be considered for TB control. A multi-site study with large sample size is needed to substantiate the current findings.
埃塞俄比亚结核病控制项目目前的做法是，在结核病筛查中排除咳嗽时间少于两周的患者，这可能导致诊断延迟，从而增加向他人传播的风险。本研究旨在确定埃塞俄比亚南部沙绍戈县四个卫生中心出现咳嗽症状的患者中涂片阳性肺结核的患病率。
2011年11月至2012年3月期间，在沙绍戈县的四个卫生中心进行了一项横断面研究。对461名年龄在五岁及以上、到门诊就诊并报告有任何时长咳嗽症状的患者，采用涂片显微镜检查法进行肺结核筛查。在数据分析过程中，根据咳嗽时长对患者进行分类，以两周为分界点。使用Stata 11版本进行数据分析。
共招募了299名咳嗽持续两周或更长时间的患者以及162名咳嗽少于两周的患者。涂片阳性肺结核的总体患病率为4.6%（95%置信区间：2.6%至7.7%）。咳嗽持续两周或更长时间的患者中涂片阳性肺结核的患病率显著高于咳嗽少于两周的患者（6.0%对1.9%；p = 0.04）。
尽管咳嗽少于两周的患者中涂片阳性肺结核的患病率较低，但考虑到诊断延迟对结核病持续传播的影响，在结核病控制中可考虑对咳嗽少于两周的患者进行筛查。需要开展一项大样本量的多地点研究来证实当前的研究结果。
