Background
Methods
Hospital A (South African platinum mine hospital 1)
Hospital B (South African platinum mine hospital 2)
Hospital C (2700-bed public sector South African tertiary-care teaching hospital)
Hospital D (1000-bed public sector UK tertiary-care teaching hospital)
Results
Patients
Hospital A (n = 56) | Hospital B (n = 26) | Hospital C (n = 20) | Hospital D (n = 13) | |
---|---|---|---|---|
Country, hospital type
| SA, mining | SA, mining | SA, teaching | UK, teaching |
% male
| 100 | 100 | 48 | 60 |
Age/y; median (range)
| 48 (26-64) | 43 (20-64) | 37 (22-61) | 46 (24-69) |
Duration of admission/days; median (range)
| 11 (1-110) | 7 (1-67) | 5 (3-32) | 38 (7-85) |
TB treatment completed previously; n (%)
| 26 (46) | 10 (39) | 3 (10) | 0 (0) |
†HIV-infected; n (%)
| 54 (96) | 23 (89) | 16 (80) | 5 (39) |
TB treated at final admission; n (%)
| 32 (57) | 16 (62) | 14 (70) | 12 (92) |
Empirical TB treatment; n (%)
| 17 (53) | 4 (25) | 6 (43) | 3 (25) |
Clinico-Pathological Comparison
Symptoms and Clinical Examination
Hospital A (n = 56) | Hospital B (n = 26) | Hospital C (n = 20) | Hospital D (n = 13) | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Omitted | Action performed | Omitted | Action performed | Omitted | Action performed | Omitted | Action performed | |||||
Absent | Present | Absent | Present | Absent | Present | Absent | Present | |||||
Symptoms elicited
| ||||||||||||
Chest complaint
|
38
|
7
|
55
|
39
|
0
|
62
|
15
|
5
|
80
|
0
|
39
|
62
|
Weight loss
|
63
|
5
|
32
|
73
|
0
|
27
|
55
|
0
|
45
|
15
|
8
|
77
|
Fever/night sweats
|
46
|
9
|
44
|
81
|
0
|
19
|
60
|
5
|
35
|
0
|
54
|
46
|
Examination
| ||||||||||||
Chest auscultation
abnormal
|
32
|
20
|
48
|
50
|
19
|
31
|
0
|
15
|
85
|
0
|
46
|
54
|
Evidence of weight
loss
|
63
|
0
|
38
|
69
|
0
|
31
|
35
|
0
|
65
|
85
|
0
|
15
|
Pleural effusion
|
39
|
52
|
9
|
96
|
0
|
4
|
80
|
5
|
15
|
39
|
31
|
31
|
Lymphadenopathy
|
86
|
5
|
9
|
89
|
12
|
0
|
40
|
45
|
15
|
31
|
23
|
46
|
Hepatosplenomegaly
|
59
|
27
|
14
|
84
|
15
|
0
|
25
|
35
|
40
|
0
|
31
|
69
|
Neck stiffness/
confusion
|
71
|
23
|
5
|
73
|
12
|
15
|
45
|
35
|
20
|
15
|
62
|
23
|
Investigations
Hospital A (n = 56) | Hospital B (n = 26) | Hospital C (n = 20) | Hospital D (n = 13) | |||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
NA | No exam | Omitted | Done | NA | No exam | Omitted | Done | NA | No exam | Omitted | Done | NA | No exam | Omitted | Done | |
Chest radiograph
|
0
| - |
38
|
63
|
0
| - |
35
|
65
|
0
| - |
35
|
65
|
0
| - |
0
|
100
|
Sputum Smear
|
0
| - |
52
|
48
|
4
| - |
42
|
54
|
10
| - |
85
|
5
|
15
| - |
0
|
85
|
Sputum Culture
|
0
| - |
75
|
25
|
4
| - |
54
|
42
|
10
| - |
90
|
0
|
15
| - |
0
|
85
|
LN aspiration
|
11
|
80
|
9
|
0
|
23
|
77
|
0
|
0
|
45
|
35
|
15
|
5
|
69
|
8
|
15
|
8
|
Pleural tap
|
66
|
21
|
2
|
11
|
0
|
96
|
0
|
4
|
10
|
70
|
0
|
20
|
69
|
8
|
8
|
15
|
Lumbar puncture
|
54
|
25
|
2
|
20
|
19
|
62
|
0
|
19
|
30
|
40
|
5
|
25
|
46
|
15
|
0
|
39
|
Other
|
25
| - |
68
|
7
|
8
| - |
89
|
4
|
10
| - |
45
|
45
|
54
| - |
0
|
46
|