Management and transference of patients diagnosed with tuberculosis in a rural hospital in southern Ethiopia

Treatment of new tuberculosis [TB] cases in Directly Observed Treatment Short Course [DOTS] programmes is believed to be the most valuable strategy for TB control. The aim of this study is to describe the experience of diagnosed cases of TB in a district hospital situated in a rural zone of Ethiopia and of "transferred out" TB cases from the hospital to their local health facilities using the DOTS programme spanning a period of 8 years. Data collection was obtained by using a TB register book in a rural district hospital from 2004 to 2011. The collected information included the type of TB, age, HIV status, and treatment outcomes using standardized definitions; 6459 patients with all forms of TB were diagnosed. Twenty-eight percent were smear-positive pulmonary TB [PTB] cases, 28.97% were smear-negative PTB cases, and 42.8% were extra-pulmonary TB [EPTB]. The global "transferred out" rate was 78.5% [5073/6459]; the "transferred out" rate after diagnosis at hospital and before starting DOTS was 72.6% [4689/6459], and after finishing the intensive phase and admission was 21.8% [385/1770]. The proportion of total cases "transferred out" in smear-negative PTB cases [70.2%] was less than smear-positive PTB cases [79.2%] [odd ratio [OR]: 0.81; 95% confidence interval [CI]: 0.76-0.87] and was higher in EPTB cases [83.3%] [OR: 1.15; 95% CI: 1.05-1.19]. The percentage of "transferred out" after hospital admission was higher in HIV-positive cases [16.8%] than in HIV-negative cases [8.5%] [OR: 2.13; 95% CI: 1.28-3.53]. In conclusion, district hospitals are still important facilities for the diagnosis of TB cases, particularly EPTB

Mammary, testicular and adnexal tuberculosis diagnosed by histology in a rural hospital in Southern Ethiopia

This study describes the experience of mammary, testicle and adnexal tuberculosis [TB] diagnosed by histological characteristics in a rural district hospital in Southern Ethiopia over a period of 7 years. During the same period, a total of 5589 TB cases were diagnosed. Fourteen cases of breast TB with a prevalence of 0.25% [95% confidence interval [CI]: 0.14-0.43], 8 cases of testicular TB [prevalence 0.14, [95% CI: 0.06-0.29]] and two ovarian TB [prevalence: 0.035 [95% CI: 0.001-0.15]]. The breast, testes and adnexal TB may mimic other conditions. Proper diagnosis is encouraged because the disease is curable with anti-TB drugs.