Are registered sputum smear-negative tuberculosis patients in Karnataka, India, diagnosed by national algorithm?
2014
SETTING : Four districts of Karnataka State, India, that
have implemented the National Tuberculosis Control
Programme (RNTCP).
OBJECTIVE : To assess the proportion of patients
diagnosed according to the nationally recommended
algorithm among new smear-negative (NSN) PTB cases
registered under the RNTCP.
METHODS: Information on 201 registered NSN-PTB
patients as regards date of initial sputum examination,
repeat sputum examination and chest X-ray (CXR) if
undertaken, treatment initiation and number of days of
antibiotic treatment after initial sputum examination,
were collected through record review and patient
interviews. In patients with negative or unknown human
immunodeficiency virus (HIV) status, the algorithm was
considered completed if the patient underwent initial
sputum examination, antibiotic trial for 710 days,
repeat sputum examination 710 days after initial sputum examination, CXR after repeat sputum examination
and anti-tuberculosis treatment 710 days after
initial sputum examination. In HIV-positive patients, the
algorithm was considered completed if CXR was
performed after or at the same time as initial sputum
examination.
RESULT S : Complete information was available for 170
patients. Of these, the algorithm was completed in 14
(8.2%, 95%CI 0.9–15.5): 1/140 patients with negative
or unknown HIV status and 13/30 HIV-positive
patients.
CONCLUSION: The algorithm was not completed in
most patients registered for treatment. Measures are
needed to improve the diagnostic process for smearnegative
PTB.
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