An evaluation of tuberculosis diagnostic methods at Pietersburg Hospital in Limpopo Province, South Africa

Abstract

Background: The World Health Organization (WHO) has embarked on a mission to reduce tuberculosis (TB) prevalence by 90% and completely eradicate TB infection by the years 2035 and 2050 respectively (Barberis, Bragazzi, Galluzzo, et al., 2017). The attainment of these two major goals will depend largely on the successful preventative measures, diagnosis, and treatment for both latent and undiagnosed active TB infections. Aim: We evaluated the nature of the various diagnostic modalities employed in the diagnosis of tuberculosis in adult patients notified as having TB at Pietersburg Hospital from January to December 2020. Methods: A retrospective descriptive, observational quantitative study based on secondary data was conducted at a tertiary hospital. The study included 135 cases of TB patients aged 12 years and above, that were notified to the infection prevention and control unit (IPCU) over a 12-month period. The data was captured using an appropriately designed data collection tool and analysed using STATA 14 (College Station, Texas 77845 USA) software. Results: A total of 135 of notified individuals with TB were analysed. The data set comprised of 57% (77/135) females and 43% (58/135) with a mean age of 37 years with an interquartile range of 29 to 45 years. Over half of the cases were notified as pulmonary TB (57.7%), while the remaining cases were notified as various forms of extra pulmonary TB. In this study, the commonest form of TB diagnostic method was imaging (92%) followed by sputum tests (55.6%), TB blood culture (52.5%), and urine LAM (36.3%), special fluid analysis (25.2%) and lastly tissue histology (3%). The commonest co-morbidity identified was HIV (92%). The urine LAM (100%) and TB blood culture (50.5%) were performed mainly in HIV positive patients. Conclusion: In this study, TB was mostly diagnosed using various imaging techniques more than microbiological tests such as sputum, urine LAM, TB blood culture, special fluid analysis or tissue histology. Furthermore, HIV emerged as the commonest co-morbid condition.