Research article

Detection of pulmonary tuberculosis among patients with cough attending outpatient departments in Dar Es Salaam, Tanzania: does duration of cough matter?

Esther S Ngadaya^1,2* , Godfrey S Mfinanga^2* , Eliud R Wandwalo^3,4* and Odd Morkve^1*

¹  Centre for International Health, University of Bergen, Bergen, Norway

²  Muhimbili Medical Research Centre, National Institute for Medical Research, Dar es Salaam, Tanzania

³  Ministry of Health and Social Welfare, National Tuberculosis and Leprosy Control Programme, (NTLP), PO Box 9083 Dar es Salaam, Tanzania

⁴  Management Sciences for Health, Dar es Salaam, Tanzania

author email corresponding author email* Contributed equally

BMC Health Services Research 2009, 9:112doi:10.1186/1472-6963-9-112

Published:	1 July 2009

Abstract

Background

According to WHO estimates, tuberculosis case detection rate in Tanzania is less than 50% and this poses a major challenge to control tuberculosis in the country. Currently, one of the defining criteria for suspecting tuberculosis is cough for two weeks or more. We wanted to find out whether the prevalence of tuberculosis was different in patients who reported cough for two weeks or more, compared to patients with cough for less than two weeks.

Methods

We conducted a cross sectional study in six health facilities in Dar es Salaam, between September and October 2007. All patients aged five years and above with cough were screened for pulmonary tuberculosis (PTB) by smear microscopy. Patients were divided into two groups, those who coughed for less than two weeks (<2 wks) and those who coughed for two weeks or more (≥ 2 wks).

Results

A total of 65,530 patients attended outpatients department (OPD). Out of these, 2274 (3.5%) patients reported cough. Among patients who reported cough, 2214 (97.4%) remembered their cough duration. One thousand nine hundred and seventy three patients (89.1%) coughed for ≥ 2 wks as compared to 241 (10.9%) patients who coughed for <2 wks. Of those who coughed for two weeks or more, 250 (12.7%) had smear positive PTB, and of those who had coughed for less than two weeks, 21 (8.7%) had smear positive PTB. There was no statistically significant difference in prevalence of smear positive tuberculosis among the two groups (Pearson Chi-Square 3.2; p = 0.074).

Conclusion

Detection of smear positive PTB among patients who coughed for less than two weeks was as high as for those who coughed for two weeks or more.