In a study conducted in the medical wards of Lilongwe Central Hospital, Malawi, 84 (18%) of 470 medical admissions were TB suspects. Of these, 21 (25%) had the diagnosis confirmed; the median length of time between admission and starting anti-TB treatment was 10 days. Of the remaining TB suspects, 24 (29%) had another diagnosis made, principally pneumonia, and 39 (46%) had no diagnosis made, with half of these patients dying under investigation in hospital. Improved and more rapid ways of managing TB suspects need to be found.
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