Errors in the diagnosis and treatment of pulmonary tuberculosis

ABSTRACT

The objective of this study was to evaluate the causes of treatment failures in patients diagnosed as pulmonary tuberculosis and started on ATT by general practitioners and general physicians. This was a descriptive observational study conducted at CMH Multan from 1st August 2004 till 31st July 2006. It included patients of all ages and both sexes. All of these patients received ATT for more than 2 months but failed to respond. All relevant investigations including sputum microscopy/culture sensitivity, bronchoscopy and CT scan chest were carried out. Total numbers of patients registered were 48. There were 27 males and 21 females and the mean age of patients was 42.75 years. Of these, 58.33% [n=28] were wrongly diagnosed. 25.02% [n=12] did not show proper compliance. 10.41% [n=5] were prescribed inadequate dosage. While 6.25 [3] were suffering from MDR-tuberculosis. Chronic bronchitis/ COPD, bronchiestasis and bronchogenic carcinoma were the commonest disease found in this series. All TB suspects should have a sputum microscopy done at the earlier stage. AFB culture/ sensitivity should be carried out whenever considered necessary. In Sputum smear negative patients high index of suspicion for non tubercular pulmonary diseases should be maintained. DOTS needs to be employed in all patients with active pulmonary tuberculosis