Setting: A provincial referral hospital in northern Thailand, where a cross-sectional study from 1995-1996 reported on the occupational risk of Mycobacterium tuberculosis transmission.
Objective: To assess the impact of acid-fast bacilli sputum smear-positive results notification to improve tuberculosis (TB) services by documenting the location of sputum collection, completing the TB register immediately, and minimising delays between hospital admission and treatment initiation.
Design: The cohort of smear-positive TB patients identified through laboratory microscopy record reviews from 1994-1999. Time from admission to hospital, laboratory diagnosis of TB, registration for treatment, and initiation of therapy were determined during the implementation of enhancing the laboratory results notification system.
Results: The number of unregistered TB patients fell from 44 cases in 1994 to none in 1999. The time elapsed from admission to treatment initiation decreased from a mean of 5.6 days in 1997 (n = 162) to 3.1 days in 1999 (n = 136) (P < 0.001). This decrease was attributed to a reduction in time between laboratory diagnosis and treatment from 2.7 days in 1997 to 0.6 days in 1999 (P < 0.001).
Conclusion: Prompt identification, isolation and treatment of TB patients occurred through an enhanced laboratory notification system. Such systems are inexpensive, improve TB care services and may reduce nosocomial transmission of M. tuberculosis.