Referral Of Patients With Chest Symptoms From Adult Out-Patient Department To Designated Microscopy Centre In A Medical College Hospital Of Kolkata

ABSTRACT

Background: Referral for microscopy plays a crucial role in case identification for pulmonary tuberculosis. Objectives: The study was conducted to assess the proportion of referral to designated microscopy centre. Methods: A cross–sectional study among 100 chest symptomatic willing patients attending adult medical outdoor department was done. Interview and prescription auditing were data collection method to assess referral. Statistical analysis was done through Epi–Info program. Results: Mean age of the patients was 41.21 years. Co–morbidity (16%) & history of contact (6%) was evaluated. Only cough, both cough and chest pains were the predominant symptoms among 39 percent, 51 percent of patients respectively. Significant amount of patients (73.58%) had no idea for duration of chest pain. Associated symptoms were low grade fever (60%), weight loss (13%). Time–interval for care–seeking was found by < 4 weeks (41%), > 4 weeks (19%), at 8 weeks (21%) and at 1st day (19%). Chest symptomatics were referred to Designated Microscopy Centre (11%) in significantly lower than referred to chest department (92%). Conclusion: The chest symptomatics were not referred to DMC at the proposed level. A sizable number of patients (21%) attended hospital for health care services after a long interval (8 weeks). Implications Sensitization of doctors on the program protocol is required to overcome the poor situation of referral to Designated Microscopy Centre.