ABSTRACT
To achieve early diagnosis in close contacts of tuberculosis patients and determine the most useful screening procedures for this purpose in Cameroon, 336 tuberculosis patients hospitalized in Unit B of the chest clinic of the Jamot Hospital in Yaounde from September 1993 to September 1994 were asked to bring their close contacts in for screening. Each contact underwent thorough clinical examination, standard postero-anterior chest X-ray, and a tuberculin skin test. If respiratory symptoms and/or chest X-ray lesions were present, acid fast bacilli (AFB) detection testing was performed on bronchial secretions. Only 104 of the 336 tuberculosis patients brought in their close contacts for evaluation. A total of 346 people were examined. Tuberculosis was detected in 50 (14.6%). Half of the new cases were under 14 years old. The most useful screening procedures tuberculosis were clinical examination, chest X-ray, and AFB testing if respiratory symptoms were present. The tuberculin skin test was not helpful.
Subject(s)
Contact Tracing/methods , Mass Screening/methods , Tuberculosis/prevention & control , Adolescent , Adult , Cameroon , Female , Hospitalization , Humans , Male , Mass Chest X-Ray , Middle Aged , Patient Acceptance of Health Care , Physical Examination , Sputum/microbiology , Tuberculin , Tuberculosis/diagnosis , Urban HealthABSTRACT
To determine and compare the efficacy of pleural fluid cytology and closed needle biopsy of the pleura in establishing the diagnosis of malignant pleural effusions in Yaounde, we reviewed the medical records of all consecutive patients with a pleural effusion admitted in unit B of the Chest Clinic of the Jamot Hospital between January 1990 and December 1994. Fifty four cases of malignant pleural effusion were diagnosed over this period. Closed needle biopsy of the pleura alone permitted a diagnosis of malignancy involving the pleura in 32 instances while cytological studies of pleural fluid provided a diagnosis in thirty six cases. A combination of both techniques was diagnostic in 48 (88.9%) patients. We recommend that both pleural fluid cytology and closed needle biopsy of the pleura be used concomitantly in the evaluation of pleural effusion for which malignancy is suspected.
