Aim: Evaluation of the contribution of general practitioners to the early diagnosis of tuberculosis in the studied period. Analysis of cases not diagnosed as active TB, from those suspected by the general practitioner and the real cases with respiratory lesions.
Material and methods: We conducted an observational epidemiologic study aiming at evaluating the diagnosis of pulmonary TB at the level of primary care medicine.
Results: The difference between conformed TB patients that have been referred with the suspicion of TB and those without suspicion is significant (p <0.0001), and the risk of disease estimated by OR was 21.54. More than half of the patients (139), had positive microscopic examination and culturing, representing 62.61%. In 10.36% microscopic examination was positive and culturing was negative (13 patients). Negative microscopic examination and positive culturing were detected in 5.86% of the patients. The majority of suspected/confirmed new patients were living in urban environments. The urban/rural ratio was 1.27. The reasons why the general practitioner suspected tuberculosis, in the order of frequency, were the following: cough/dry cough, sweating/nocturnal sweating, fever/persisting fever. Among the TB types, we noted the large percentage of patients with infiltrating, nodular tuberculosis confined to the volume of one pulmonary segment (30.78%), and 19.87% of the cases were multicavity tuberculosis; also, we noted the presence of caseous tuberculosis with moderate volumes of infiltrates, confined to a pulmonary lobe (18.27%).
Conclusion: Early diagnosis of tuberculosis in the primary healthcare network is a continuous challenge for the general practitioner.
Tag Archives: tuberculosis
Pulmonary Tuberculosis Wheezing in Early Childhood
Background: Primary pulmonary tuberculosis in children and infants can be suggested by the presence of a wheezing, often interpreted as acute bronchiolitis or asthma. The objective of this study is to assess the frequency and mechanism of wheezing in infants and toddlers with tuberculosis and to assess its value as an alarm symptom in children from areas where tuberculosis incidence is high.
Material and method: We carried out a retrospective study in the Pediatric Clinic of the ”Filantropia” Municipal Hospital Clinic of Craiova between 2007–2011. We studied 25 children and infants, who at hospitalization presented signs like: wheezing, cough and dyspnoea.
Results: There were 25 children and infants diagnosed with primary tuberculosis. Twenty-one cases (84%) came from rural areas and 56% (14 cases) occurred in infants. Out of the 25 cases, 22 (88%) presented wheezing, 18 (72%) were accompanied by dyspnoea and 16 patients (64%) presented cough. The majority of cases (16 out of 25, representing 64%) came from families in which a tuberculosis focus was identified during the epidemiological investigation.
Conclusions: The positive epidemiological research, together with other data provided by the clinical, laboratory analyses and the collaboration with other specialties determine the classification of wheezing as a symptom within tuberculosis.