CLINICAL AUDIT ON THE MANAGEMENT OF EXTRA-PULMONARY TUBERCULOSIS, JIMMA HOSPITAL

Abstract

BACKGROUND: Tuberculosis is a chronic bacterial infection that primarily attacks the lungs, which may also affect the kidneys, bones, lymph nodes, and the brain. Tuberculosis causes 2 million deaths each year. The world Health Organization (WHO) predicts that between 2000 and 2020, nearly 1 billion people will become infected with the bacterium and about 35 million people will die from the disease. In Ethiopia, tuberculosis is one of the leading causes of morbidity and mortality. The aim of the study was to review the management of extra pulmonary tuberculosis based on the National Tuberculosis and Leprosy Control Program manual

METHODS: This retrospective study was conducted on the management of extra pulmonary tuberculosis in Jimma hospital. Data was collected on prepared format from patients' records and National Tuberculosis and Leprosy Control Program manual.

R ESULTS: A total of 112 extra pulmonary tuberculosis patients visited Jimma hospital TB clinic front November 22/1998 to June 24/1999, and all were included in the study. Mean age of patients was 28 years and the male to female ratio was 1:1.3. The majority (95.5%) were new cases, which have never been treated for tuberculosis previously. Among the extra pulmonary tuberculosis forms, tuberculoses lymphadenitis was the commonest (41.1%) followed by tuberculous pleurisy (2 7. 7 %). Presenting complaints were recorded in 74(66.1%) of patients. Weight was recorded in 70 (62.5%) of patients with mean weight of 49.1 Kg. Erythrocyte sedimentation rate (E.SR) was determined in 72(64%) patients with mean value of 66.2 mm/hr. Radiological investigation was done in 44(39.3%) patients of which 36 are chest X-rays. Fine needle aspiration cytology (FNAC) was done for 33 patients of whom 31 were consistent with tuberculosis. Long course chemotherapy (LCC), DOTS and retreatment regimens were used in 90, 7 and 1 patients respectively. Thirteen (11.6%) patients were treat_ed _tr

treatment.

_{o en}b _t.y drug regimens that arc not mentioned on the NTLCP manual. Forty (36%) patients were completed treatment, 35(31%) were transferred out, and 32(29%) interrupted

CONCLUSION: The study showed incomplete recordings of history and physical finding, ⁱnaPPropriate disease categorization and selection of treatment regimens, hence, poor compliance to the 1997 NTLCP manual. Refreshment and training workshop for health professionals on the use of NTLCE manuals and continuous clinical audit with appropriate feedback are recommended.