Suspected pulmonary tuberculosis in rural South Africa - Sputum induction as a simple diagnostic tool?
Objectives. To assess the value of sputum induction (SI) as a diagnostic tool for patients with suspected pulmonary tuberculosis (PTB) who are unable to expectorate or who have a negative sputum smear,
Design, Study of an inpatient cohort undergoing SL
Setting, Mseleni Hospital, a rural district hospital in northern KwaZulu-Natal.
Subjects. All adult patients with suspected TB seen at the hospital over a 4-month period,
Outcome measures, (i) Successful SI; (ii) sputum acid-fast smear result; (iii) change of admission diagnosis as a result of the induction procedure; and (iv) number of patients discharged with a diagnosis other than TB who represented within 4 months with TB,
Results, A total of 51 patients (31 female) underwent SI; of these 36 (71 %) were able to produce a sputum sample, Fifteen (42%) of those were acid-fast smear-positive (29% of all patients included), The admission diagnosis was changed in 16 (44%) of the patients who were able to give an induced sputum sample as opposed to 4 (27%) who had been unable to expectorate despite an induction attempt (P = 038). Three (125%) of the 24 patients with a discharge diagnosis other than TB (17 pneumonia, 3 old TB, 2 carcinoma of the lung, 1 bronchiectasis) turned out to have TB within the follow-up period; 2 of those had extrapulmonary TB
Conclusion, SI produced a positive smear result in 29% of patients with suspected TB who had previously been smear-negative or unable to expectorate. The method proved an aid to clinical decision making.
Copyright remains in the Author’s name. The work is licensed under a Creative Commons Attribution - Noncommercial Works License. Authors are required to complete and sign an Author Agreement form that outlines Author and Publisher rights and terms of publication. The Agreement form should be uploaded along with other submissions files and any submission will be considered incomplete without it [forthcoming].
Material submitted for publication in the SAMJ is accepted provided it has not been published or submitted for publication elsewhere. Please inform the editorial team if the main findings of your paper have been presented at a conference and published in abstract form, to avoid copyright infringement. The SAMJ does not hold itself responsible for statements made by the authors.
Previously published images
If an image/figure has been previously published, permission to reproduce or alter it must be obtained by the authors from the original publisher and the figure legend must give full credit to the original source. This credit should be accompanied by a letter indicating that permission to reproduce the image has been granted to the author/s. This letter should be uploaded as a supplementary file during submission.