Case finding for pulmonary tuberculosis, Queen Elizabeth Central Hospital, Blantyre, Malawi.

Setting: Queen Elizabeth Central Hospital, Malawi.

Objective: To evaluate the investigation of patients with cough who attend out-patient services and the adherence to recommended diagnostic protocols.

Design: Two operational studies in 1995: 1) an audit of management of patients presenting to non-fee-paying out-patient services (OPD) with cough, and 2) an audit of the laboratory sputum register and the OPD cough register.

Screening pulmonary tuberculosis suspects in Malawi: testing different strategies.

Alternative strategies for screening tuberculosis (TB) suspects are needed in sub-saharan Africa. Ambulatory adult TB suspects who were seen in the chronic cough room of Queen Elizabeth Central Hospital, Blantyre, Malawi, were assessed with respect to appropriateness of referral. Appropriate referrals (patients with cough 3 weeks or longer, weight loss and no antibiotic response) were screened by 3 sputum specimens for microscopy and culture of Mycobacterium tuberculosis and chest radiography (CXR).

Tuberculous lymphadenitis, a diagnostic problem in areas of high prevalence of HIV and tuberculosis.

The human immunodeficiency virus (HIV) epidemic is associated with a marked increase of tuberculosis cases. The influence of HIV on diagnostic methods for tuberculous lymphadenitis is less clear. In an environment of high HIV and tuberculosis prevalence in Blantyre, Malawi, a prospective study compared results of basic procedures diagnosing tuberculous lymphadenitis with the outcome of histology and/or culture.

Delays in diagnosis and treatment of smear-positive tuberculosis and the incidence of tuberculosis in hospital nurses in Blantyre, Malawi.

There is little information about nosocomial transmission of tuberculosis (TB) in sub-Saharan Africa. A study was carried out to examine the process of diagnosis and treatment of smear-positive pulmonary TB patients in Queen Elizabeth Central Hospital, Blantyre, Malawi, and the incidence of TB in nurses working in specific departments of the hospital. Case notes of 1365 patients with smear-positive pulmonary TB, diagnosed and treated at the hospital in 1993 and 1994, were analysed.