Pulmonary tuberculosis: missed case in the routine hospital investigations of contacts

ABSTRACT

To assess hospital performance towards case finding among contacts and to find out the value of polymerase chain reaction [PCR] testing in detection of missed cases, 120 pulmonary tuberculous patients were considered index cases. Their contacts were enlisted. Hospital measures towards contacts were audited through interviews with the hospital personnel and revision of the hospital records. Eighty non tuberculous contacts as revealed by the hospital routine measures were subjected to polymerase chain reaction [PCR]. The study revealed that cases among contacts might be missed due to omitting examination of contacts other than the household ones. Also, some of the enlisted contacts might not attend due to non competence of the calling system, The hospital applied routine investigations failed in detection of some of the cases. The study revealed also that clinically suspected contacts might be managed as tuberculous cases to avoid missing cases. The study recommended enlistment of contacts other than the household ones. It recommended also direct mailing and communications with the primary health care units besides home visits to reach tuberculous contacts