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IMPROVEMENT IN CASE-FINDING IN DISTRICT TUBERCULOSIS
PROGRAMME BY EXAMINING ADDITIONAL SPUTUM SPECIMENS |
MA Seetha GE Rupert Samuel & N Parimala: Indian
J TB 1990, 37, 139-44. |
A study was conducted to augment Case-finding in
the programme by increasing case yield through repeated sputum examinations
by collecting 2-3 samples on the same day. The study was conducted
in nine Peripheral Health Institutions (PHIs) of Bangalore district.
They were all Microscopy Centres and were drawn on the basis of
random allocation. A Health Visitor (HV), Laboratory Technician
and Laboratory Attendants of National TB Institute (NTI) were posted
at the PHIs during the entire study period. After collection of
first sputum sample from the eligible chest symptomatics, 2nd, 3rd
or 4th samples were collected at an interval of half an hour from
those whose first specimen was negative. Separate smears were prepared
from all the specimens for examination at NTI. The duration of the
study was nine months.
From among 4233 total new outpatients, 458 chest
symptomatics were identified. Of them, 451 gave the first specimen,
416 the second specimen and 379 and 332 the 3rd and 4th specimen
respectively. There were a total of 25 smear positive cases; 18
were detected by the first specimen, 3 were added by second and
the remaining 4 by the 4th specimen. Of the 451 chest symptomatics,
185 were selected by the PHI Medical Officers (MOs) and 266 were
picked up by the NTI HVs from the remaining outpatients. Of the
25 cases detected, 10 came from the chest symptomatics selected
by the MOs and 15 came from those selected by the NTI HV. The study
has shown the feasibility of collecting multiple specimens of sputum
from each symptomatic on the same day. A loss of 60% cases was due
to casual symptom questioning by the MOs. It was further observed
that the intensity of the physical suffering has influenced the
behaviour of patients towards action taking. The sputum positivity
rate was 5.5%
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KEY WORDS: CASE-FINDING, CONTROL PROGRAMME,
SPUTUM EXAMINATION. |