Quality of diagnosis and monitoring of tuberculosis in Northern Ethiopia: medical records-based retrospective study

Trop Doct. 2015 Oct;45(4):214-20. doi: 10.1177/0049475515581126. Epub 2015 Apr 15.

Abstract

Objectives: To determine quality of diagnosis and monitoring of treatment response of patients with smear-negative pulmonary tuberculosis (TB) compared with smear-positive cases in Ethiopia.

Methods: A retrospective analysis of medical records of newly diagnosed pulmonary TB cases that were registered for taking anti-TB medication and had completed treatment between 2010 and 2012. We evaluated the percentage of cases that were managed according to the International Standards of Tuberculosis Care (ISTC) and compared smear-negative with smear-positive cases.

Results: We analysed 1168 cases of which 742 (64%) were sputum smear-negative cases. Chest radiography examination at diagnosis and microbiological testing at the end of the intensive phase of treatment was performed in a smaller proportion than in smear-positive TB cases (70% vs. 79%, P value <0.001) and (70% vs. 95%, P value <0.001), respectively.

Conclusions: Clinical actions recommended in the ISTC are of greatest importance in minimising pitfalls in care of smear-negative TB yet were performed less often in smear-negative than smear-positive TB cases.

Keywords: Quality deficits; healthcare facility; performance indicators; standards.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Ethiopia
  • Female
  • Humans
  • Male
  • Medical Records
  • Middle Aged
  • Process Assessment, Health Care
  • Retrospective Studies
  • Sputum / microbiology
  • Tuberculosis, Pulmonary / diagnosis*
  • Tuberculosis, Pulmonary / microbiology
  • Young Adult