Diagnosis and Treatment Outcome of Smear Positive Pulmonary Tuberculosis: Retrospective study in Kpando Municipal, Ghana

Background: Smear microscopy remains the primary tool for the detection of tuberculosis in Ghana. Laboratory diagnosis of active tuberculosis cases by sputum smear microscopy is a critical component of Directly Observed Treatment, Shortcourse (DOTS). Effective control of tuberculosis in Ghana at the rural level therefore hinges on the quality of local laboratory to provide accurate and reliable direct acid fast bacilli microscopy testing for diagnosis, treatment and monitoring.

Method: A retrospective trend analysis of laboratory entry records of tuberculosis (TB) cases from the Anfoega Catholic Hospital of the Kpando Municipal District in the Volta region from January 2013 to December 2015 was conducted. Patients were diagnosed according to the National TB programme Control guidelines. Data were computed into statistical software and analyzed for descriptive statistics, odds ratio and chi-square at 95% confidence interval. A p-value < 0.05 was considered statistically significant.

Results: Of the 116 cases recorded during the study period, 54 (46.6%) were found to be smear positive pulmonary tuberculosis and was highest among 21-40 year group. Annual prevalence generally decreased during the study from 31 (57.4%) to 11 (32.4%) with corresponding increase in treatment success rate. The proportion of new smear positives decreased from 27 (50.0%) in 2013 to 11(20.4%) in 2014 and 2015 respectively while new smear negatives also reduced from 19 (30.6%) in 2013 to 15 (24.2%) in 2014 but rose to 18 (29.1%) in 2015. High smear positivity was observed among males 33 (61.1%) than in females 21 (38.9%). 113(97%) of the 116 patients had their HIV status tested. Of these, 24 (21.2%) were HIV positive. 9 (7.9%) out of the 113 were found to be co-infected with Pulmonary tuberculosis.

Conclusion: Treatment outcome was statistically associated with age group but not with sex and was more successful among TB only patients compared to patients with TB/HIV co-infection, and HIV prevalence among smear negatives were higher than smear positives.